Journal articles on the topic 'Healthcare programmes'
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Cronin, Camille. "Workplace learning – a healthcare perspective." Education + Training 56, no. 4 (May 6, 2014): 329–42. http://dx.doi.org/10.1108/et-03-2013-0039.
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Purpose – The purpose of this paper is to explore the complex relationship between the learner and the learning environment. As a method case study research was employed to examine the student's experience of the learning environment. Work experience is considered to be an essential course requirement for vocational programmes throughout the world. This paper exclusively describes the learning environment and presents a number of significant processes that the learner experiences, each one having an impact on the learning experience. This paper will be of interest to policy makers, academics and educators who face the challenge of trying to understand how students learn in the workplace. Design/methodology/approach – Case study research was used to systematically investigate the learning environments and examine five students’ experience of learning in healthcare settings which included nurseries, nursing homes and hospitals while studying on a two-year health studies Further Education (FE) programme. Through critical incident interviews, observations and documentation data were collected and analysed. Findings – This study has identified the learning environment as a complex entity comprising of six significant processes: physical environment, interaction communication, self-awareness, tasks, feelings and learning. These processes illustrate the multidimensional nature of the learning environment, how dependent they are on each other and how they coexist within the learning environment. Practical implications – In studying this particular student group many similarities have been found with pre-registration nurses and other professional groups studying on undergraduate programmes in higher education who rely on the “workplace” for learning, particularly where the workplace may provide up to half the educational experience in a programme's curriculum. Social implications – This study only really provides a snapshot of a number of healthcare settings that exist in one geographical area, and coupled with the size of the sample itself further limits the study. However, what is inherent in qualitative research particularly in a case study design is the focus on in-depth contextual data. Originality/value – This paper is unique as it examines the learning experience of students on a health studies programme in FE. It describes and discusses their experience of workplace learning.
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Braithwaite, Jeffrey, Kristiana Ludlow, Luke Testa, Jessica Herkes, Hanna Augustsson, Gina Lamprell, Elise McPherson, and Yvonne Zurynski. "Built to last? The sustainability of healthcare system improvements, programmes and interventions: a systematic integrative review." BMJ Open 10, no. 6 (June 2020): e036453. http://dx.doi.org/10.1136/bmjopen-2019-036453.
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IntroductionThe sustainability of healthcare delivery systems is challenged by ageing populations, complex systems, increasing rates of chronic disease, increasing costs associated with new medical technologies and growing expectations by healthcare consumers. Healthcare programmes, innovations and interventions are increasingly implemented at the front lines of care to increase effectiveness and efficiency; however, little is known about how sustainability is conceptualised and measured in programme evaluations.ObjectivesWe aimed to describe theoretical frameworks, definitions and measures of sustainability, as applied in published evaluations of healthcare improvement programmes and interventions.DesignSystematic integrative review.MethodsWe searched six academic databases, CINAHL, Embase, Ovid MEDLINE, Emerald Management, Scopus and Web of Science, for peer-reviewed English journal articles (July 2011–March 2018). Articles were included if they assessed programme sustainability or sustained outcomes of a programme at the healthcare system level. Six reviewers conducted the abstract and full-text review. Data were extracted on study characteristics, definitions, terminology, theoretical frameworks, methods and tools. Hawker’s Quality Assessment Tool was applied to included studies.ResultsOf the 92 included studies, 75.0% were classified as high quality. Twenty-seven (29.3%) studies provided 32 different definitions of sustainability. Terms used interchangeably for sustainability included continuation, maintenance, follow-up or long term. Eighty studies (87.0%) clearly reported the timepoints at which sustainability was evaluated: 43.0% at 1–2 years and 11.3% at <12 months. Eighteen studies (19.6%) used a theoretical framework to conceptualise or assess programme sustainability, including frameworks that were not specifically designed to assess sustainability.ConclusionsThe body of literature is limited by the use of inconsistent definitions and measures of programme sustainability. Evaluations of service improvement programmes and interventions seldom used theoretical frameworks. Embedding implementation science and healthcare service researchers into the healthcare system is a promising strategy to improve the rigour of programme sustainability evaluations.
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Perveen, Shagufta, Zohra S. Lassi, Mohammad Afzal Mahmood, Henry B. Perry, and Caroline Laurence. "Application of primary healthcare principles in national community health worker programmes in low-income and middle-income countries: a scoping review." BMJ Open 12, no. 2 (February 2022): e051940. http://dx.doi.org/10.1136/bmjopen-2021-051940.
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ObjectiveTo identify which primary healthcare (PHC) principles are reflected in the implementation of national community health worker (CHW) programmes and how they may contribute to the outcomes of these programmes in the context of low-income and middle-income countries (LMICs).DesignScoping review.Data sourcesA systematic search was conducted through PubMed, CINAHL, EMBASE and Scopus databases.Eligibility criteriaThe review considered published primary studies on national programmes, projects or initiatives using the services of CHWs in LMICs focused on maternal and child health. We included only English language studies. Excluded were programmes operated by non-government organisations, study protocols, reviews, commentaries, opinion papers, editorials and conference proceedings.Data extraction and synthesisWe reviewed the application of four PHC principles (universal health coverage, community participation, intersectoral coordination and appropriateness) in the CHW programme’s objectives, implementation and stated outcomes. Data extraction was undertaken systematically in an excel spreadsheet while the findings were synthesised in a narrative manner. The quality appraisal of the selected studies was not performed in this scoping review.ResultsFrom 1280 papers published between 1983 and 2019, 26 met the inclusion criteria. These 26 papers included 14 CHW programmes from 13 LMICs. Universal health coverage and community participation were the two commonly reported PHC principles, while intersectoral coordination was generally missing. Similarly, the cultural acceptability aspect of the principle of appropriateness was present in all programmes as these programmes select CHWs from within the communities. Other aspects, particularly effectiveness, were not evident.ConclusionThe implementation of PHC principles across national CHW programmes in LMICs is patchy. For comprehensiveness and improved health outcomes, programmes need to incorporate all attributes of PHC principles. Future research may focus on how to incorporate more attributes of PHC principles while implementing national CHW programmes in LMICs. Better documentation and publications of CHW programme implementation are also needed.
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IJsbrandy, Charlotte, Wim H. van Harten, Winald R. Gerritsen, Rosella P. M. G. Hermens, and Petronella B. Ottevanger. "Healthcare professionals’ perspectives of barriers and facilitators in implementing physical activity programmes delivered to cancer survivors in a shared-care model: a qualitative study." Supportive Care in Cancer 28, no. 7 (December 2, 2019): 3429–40. http://dx.doi.org/10.1007/s00520-019-05108-1.
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Abstract Background The positive impact of physical activity programmes has been recognised, but the current uptake is low. Authorities believe delivering these programmes in a shared-care model is a future perspective. The present study aimed to identify the barriers and facilitators affecting physical activity programme implementation in a shared-care model delivered with the cooperation of all the types of healthcare professionals involved. Methods Thirty-one individual interviews with primary healthcare professionals (PHPs) and four focus group interviews with 39 secondary healthcare professionals (SHPs) were undertaken. We used Grol and Flottorp’s theoretical models to identify barriers and facilitators in six domains: (1) physical activity programmes, (2) patients, (3) healthcare professionals, (4) social setting, (5) organisation and (6) law and governance. Results In the domain of physical activity programmes, those physical activity programmes that were non-tailored to the patients’ needs impeded successful implementation. In the domain of healthcare professionals, the knowledge and skills pertaining to physical activity programmes and non-commitment of healthcare professionals impeded implementation. HCPs expressed their concerns about the negative influence of the patient’s social network. Most barriers occurred in the domain of organisation. The PHPs and SHPs raised concerns about ineffective collaboration and networks between hospitals. Only the PHPs raised concerns about poor communication, indeterminate roles, and lack of collaboration with SHPs. Insufficient and unclear insurance coverage of physical activity programmes was a barrier in the domain of law and governance. Conclusions Improving the domain of organisation seems the most challenging because the collaboration, communication, networks, and interactive roles between the PHPs and SHPs are all inadequate. Survivor care plans, more use of health information technology, improved rehabilitation guidelines, and better networks might benefit implementing physical activity programmes.
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Huang, Yuan-Han, Linlin Ma, Luke A. Sabljak, and Zachary A. Puhala. "Development of sustainable community paramedicine programmes: a case study in Pennsylvania." Emergency Medicine Journal 35, no. 6 (April 17, 2018): 372–78. http://dx.doi.org/10.1136/emermed-2017-207211.
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BackgroundCommunity paramedicine (CP) models have been applied across rural and urban communities in support of healthcare delivery systems for nearly two decades. However, there is still insufficient information regarding the development of sustainable CP programmes. This study explores the strategies used by active CP programmes and investigates their operational statuses, community demographics, financial models and challenges for programme development.MethodsA series of interviews was conducted with four CP programmes in Pennsylvania, USA, which are affiliated with a local government, a health system, an ambulance service and an emergency medical service, respectively. Each CP programme uses its own model with unique goals, as well as providing corresponding services/care based on the demands from their communities.ResultsThree CP programmes in the study were mainly aimed at reducing healthcare resource utilisation (ie, reduce readmissions or ED utilisation), but one of the programmes developed a sustainable model aiding newborn care in the community. Establishing a solid reimbursement mechanism and working closely with collaborators are two major strategies for developing sustainable CP programmes. Complete data collection and a programme evaluation process will also be important to demonstrate the value of its CP models to potential collaborators and policy-makers. However, the cost-effectiveness of a CP model is still not easy to identify due to the separate programmes being developed without uniform goals.ConclusionThe challenges and solutions from the four programmes under study can provide a road map for the development of CP programmes for other communities.
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Pollack, Todd M., Vo Thi Tuyet Nhung, Dang Thi Nhat Vinh, Duong Thi Hao, Le Thi Thu Trang, Pham Anh Duc, Nguyen Van Kinh, et al. "Building HIV healthcare worker capacity through telehealth in Vietnam." BMJ Global Health 5, no. 4 (April 2020): e002166. http://dx.doi.org/10.1136/bmjgh-2019-002166.
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Development of a robust technical assistance system is an essential component of a sustainable HIV response. Vietnam’s National HIV Program is transitioning from a largely donor-funded programme to one primarily supported by domestic resources. Telehealth interventions are increasingly being used for training, mentoring and expert consultation in high-resource settings and hold significant potential for use as a tool to build HIV health worker capacity in low and middle-income countries. We designed, implemented and scaled up a novel HIV telehealth programme for Vietnam, with the goal of building a sustainable training model to support the country’s HIV workforce needs. Over a 4-year period, HIV telehealth programmes were initiated in 17 public institutions with participation of nearly 700 clinical sites across 62 of the 63 provinces in the country. The telehealth programme was used to deliver certificate training courses, provide clinical mentoring and case-based learning, support programme implementation, provide coaching in quality improvement and disseminate new guidelines and policies. Programme evaluation demonstrated improved health worker self-reported competence in HIV care and treatment and high satisfaction among the programme participants. Lessons learnt from Vietnam’s experience with telehealth can inform country programmes looking to develop a sustainable approach to HIV technical assistance and health worker capacity building.
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Zafiropoulos, George. "Educational programmes: Saving money in healthcare." British Journal of Healthcare Management 21, no. 12 (December 2, 2015): 571–76. http://dx.doi.org/10.12968/bjhc.2015.21.12.571.
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Shi, Jianwei, Qingfeng Du, Xin Gong, Chunhua Chi, Jiaoling Huang, Wenya Yu, Rui Liu, et al. "Is training policy for general practitioners in China charting the right path forward? a mixed methods analysis." BMJ Open 10, no. 9 (September 2020): e038173. http://dx.doi.org/10.1136/bmjopen-2020-038173.
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ObjectivesSince 2010, the Chinese government has gradually increased its investment in the training of general practitioners (GPs) to support their role as ‘gatekeepers’ in the healthcare system. However, this training is still organised from the perspective of specialist care. We aimed to assess the appropriateness of the principal GP admission training programme curricula in China, including Residents Training for GPs (RTGP), Residents Training for Assistant GPs (RTAGP) and Training for Specialists with General Practice interest (TSGP).SettingThe study focussed on GP training programmes in Shanghai, China.ParticipantsData on disease competences developed in three GP clinical training programmes (RTGP, RTAGP and TSGP) were derived from official programme training manuals. Data on the proportion of outpatient visits for each disease were taken from the Shanghai community healthcare centres grassroots outpatient database.Primary and secondary outcome measuresWe first conducted a quantitative analysis by comparing the structure of current training curricula with actual outpatient utilisation patterns across all community healthcare institutions in Shanghai from 2014 to 2018. Qualitative analysis was then conducted to evaluate GP training programmes based on Donabedian’s model.ResultsQuantitative analysis showed that the distribution of diseases for which competences were taught did not match the composition of outpatient visits in community healthcare institutions. Concerns identified through qualitative analysis included teachers who were mostly specialists, lack of equipment for differential diagnosis in community healthcare institutions, insufficient teaching of referral standards and GP training in large hospitals that consistently neglected communication skills.ConclusionsThe establishment and implementation of admission training programmes for GPs in China lacks a focus on general practice training and may be improved by adopting an evidence-based general perspective aligned with the medical needs of the community.
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Weier, Naomi, Dilip Nathwani, Karin Thursky, Thomas Tängdén, Vera Vlahović-Palčevski, Oliver Dyar, Bojana Beović, et al. "An international inventory of antimicrobial stewardship (AMS) training programmes for AMS teams." Journal of Antimicrobial Chemotherapy 76, no. 6 (March 19, 2021): 1633–40. http://dx.doi.org/10.1093/jac/dkab053.
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Abstract Background Healthcare professionals are increasingly expected to lead antimicrobial stewardship (AMS) initiatives. This role in complex healthcare environments requires specialized training. Objectives Little is known about the types of AMS training programmes available to clinicians seeking to play a lead role in AMS. We aimed to identify clinicians’ awareness of AMS training programmes, characteristics of AMS training programmes available and potential barriers to participation. Methods AMS training programmes available were identified by members of the ESCMID Study Group for Antimicrobial Stewardship (ESGAP) via an online survey and through an online search in 2018. Individual training programme course coordinators were then contacted (September–October 2018) for data on the target audience(s), methods of delivery, intended outcomes and potential barriers to accessing the training programme. Results A total of 166/250 ESGAP members (66%) responded to the survey, nominating 48 unique AMS training programmes. An additional 32 training programmes were identified through an online search. AMS training programmes were from around the world. Less than half (44.4%) of respondents were aware of one or more AMS training programmes available, with pharmacists more aware compared with medical doctors and other professionals (73% versus 46% and 25%, respectively). AMS training programmes were most commonly delivered online (59%) and aimed at medical doctors (46%). Training costs and a lack of recognition by health professional societies were the most frequently cited barriers to participation in AMS training programmes. Conclusions The development of a systematic inventory of AMS training programmes around the globe identifies opportunities and limitations to current training available. Improving access and increasing awareness amongst target participants will support improved education in AMS.
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Tseung, Victrine, Susan Jaglal, Nancy Margaret Salbach, and Jill I. Cameron. "A Qualitative study assessing organisational readiness to implement caregiver support programmes in Ontario, Canada." BMJ Open 10, no. 5 (May 2020): e035559. http://dx.doi.org/10.1136/bmjopen-2019-035559.
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ObjectiveTo qualitatively explore factors affecting implementation of caregiver support programmes in healthcare institutions in a regional stroke system.DesignA qualitative descriptive study with the Ontario Stroke System (OSS) was conducted. Data were collected through focus groups and in-depth interviews. Transcripts were coded and analysed using inductive thematic analysis.SettingRegional Stroke System, Ontario, Canada.ParticipantsOSS stakeholders including medical directors, executives, programme directors, education coordinators, rehabilitation and community and long-term care specialists, primary care leaders and healthcare professionals.InterventionNot applicable.Main outcome measuresData collection explored perceptions of the need for caregiver support programmes and factors that may affect their implementation.ResultsFour focus groups (n=43) and 29 interviews were completed. Analyses identified themes related to (1) evidence that a caregiver programme will improve health and health system outcomes, (2) personnel requirements, (3) barriers associated with current billing and referral processes and (4) integration with current practice and existing workflow processes.ConclusionsImplementation strategies to adopt caregiver programmes into clinical practice should incorporate evidence and consider personnel and existing workflow processes.
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Van Vleet, Stacey. "Children’s Healthcare and Astrology in the Nurturing of a Central Tibetan Nation-State, 1916–24." Asian Medicine 6, no. 2 (September 15, 2012): 348–86. http://dx.doi.org/10.1163/15734218-12341238.
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Abstract Between 1916 and 1924, a Tibetan public healthcare programme that focused on childcare and natal astrology comprised a central aspect of the mission of the Lhasa Mentsikhang (Institute of Medicine and Astrology). Assessing previously unused Tibetan language materials—including the Thirteenth Dalai Lama’s edict for implementation and an accompanying childcare manual—the programme is contextualized with regard to regional developments in British India and China. Like British ‘mothercraft’ education programmes of the same period, the Tibetan initiative links the health of the population (from infancy) to the health of the state and its economy. Rather than appealing to the authority of ‘scientific’ colonial medicine, however, this paper discusses how indigenous medical techniques and theories are put forward as effective means to prove the nascent Central Tibetan state’s benevolence, legitimacy and sovereignty via intervention in the domestic sphere. Such attention to medical reform and to the domestic sphere brings light to an underappreciated effort by the Thirteenth Dalai Lama to cultivate a sense of Tibetan subjecthood and to reconfigure the relationship between his government and various segments of society. Significantly, this childcare initiative was entrusted not just to mothers, and the category of class is here more germane than the category of gender central within British programmes. Various social groups within a specifically delineated Tibetan territory are assigned tasks in the programme’s implementation, illustrating the desire to incorporate each into a reorganised Tibetan state bound by a newly articulated Buddhist ideal of shared social responsibility.
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Dos Santos, Luis. "Rural Public Health Workforce Training and Development: The Performance of an Undergraduate Internship Programme in a Rural Hospital and Healthcare Centre." International Journal of Environmental Research and Public Health 16, no. 7 (April 9, 2019): 1259. http://dx.doi.org/10.3390/ijerph16071259.
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Workforce shortages in the field of public health and healthcare are significant. Due to the limitations of career opportunities and compensation, rural hospitals and healthcare centres usually have on-going career openings for all departments. As a result, university departments of public health and healthcare management, and rural hospitals and health centres may need to establish internship and training programmes for undergraduate senior-year students in order to provide opportunities and human resource opportunities for both students and public health professions. The research examined the performance, feedback, and opinions of a university-based one-year-long on-site internship training programme between a university public health and healthcare undergraduate department and a regional hospital and healthcare centre in a rural region in the United States. Individual interview data were collected from management trainees and focus group activities data were collected from hospital departmental supervisors who have completed this one-year-long on-site internship training programme. The results offered an assessment of performance and evaluation of how a one-year-long internship programme could be beneficial to hospitals and health centres in the areas of human resources, manpower management, and skill training to prospective professionals in rural and regional communities. Also, the study provided a blueprint and alternative for universities and partnered sites to redesign and improve their current internship programmes which may better fit their needs for their actual situations.
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Cecon, Natalia, Theresia Krieger, Sandra Salm, Holger Pfaff, and Antje Dresen. "Salutogenesis at Work as a Facilitator for Implementation? An Explorative Study on the Relationship of Job Demands, Job Resources and the Work-Related Sense of Coherence within a Complex Healthcare Programme." International Journal of Environmental Research and Public Health 19, no. 3 (February 6, 2022): 1842. http://dx.doi.org/10.3390/ijerph19031842.
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Background: The implementation of complex healthcare programmes can be challenging for respective service providers (SPs) in implementation settings. A strong work-related sense of coherence (Work-SoC) promotes creation of job resources and potentially facilitates coping with demands that may arise during implementation. In this study, we analyse how SPs’ Work-SoC is influenced by job resources and demands during programme implementation and identify relevant implementation strategies to ensure a salutogenic implementation process. Methods: Qualitative data were collected during the implementation of a new complex psycho-oncological care programme called isPO. Four focus groups and four interviews were conducted with SPs. All were audiotaped, transcribed and content analysis was applied, whilst ensuring inter- and intra-rater reliability. Results: Each Work-SoC component was influenced by specific job resources and demands. In particular, comprehensibility and manageability interacted. Manageability affected assessment of the programme’s feasibility. High meaningfulness positively affected the programme’s acceptance and overall assessment among SPs. Furthermore, it buffered low manageability and was strongly associated with project identification. Conclusion: We found that Work-SoC could be used to assess SPs’ work environment, and therefore programme feasibility. It may be worthwhile to use Work-SoC as an implementation outcome or as an indicator for possible programmes.
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White, Joseph. "The challenge of budgeting for healthcare programmes." OECD Journal on Budgeting 14, no. 1 (December 22, 2014): 73–107. http://dx.doi.org/10.1787/budget-14-5jxst2mfm923.
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Rawaf, S. "Current Issues in Healthcare Health Improvement Programmes." Public Health 114, no. 5 (September 2000): 426. http://dx.doi.org/10.1016/s0033-3506(00)00379-6.
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Ang, Ian Yi Han, Chuen Seng Tan, Milawaty Nurjono, Xin Quan Tan, Gerald Choon-Huat Koh, Hubertus Johannes Maria Vrijhoef, Shermin Tan, Shu Ee Ng, and Sue-Anne Toh. "Retrospective evaluation of healthcare utilisation and mortality of two post-discharge care programmes in Singapore." BMJ Open 9, no. 5 (May 2019): e027220. http://dx.doi.org/10.1136/bmjopen-2018-027220.
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ObjectiveTo evaluate the impact on healthcare utilisation frequencies and charges, and mortality of a programme for frequent hospital utilisers and a programme for patients requiring high acuity post-discharge care as part of an integrated healthcare model.DesignA retrospective quasi-experimental study without randomisation where patients who received post-discharge care interventions were matched 1:1 with unenrolled patients as controls.SettingThe National University Health System (NUHS) Regional Health System (RHS), which was one of six RHS in Singapore, implemented the NUHS RHS Integrated Interventions and Care Extension (NICE) programme for frequent hospital utilisers and the NUHS Transitional Care Programme (NUHS TCP) for high acuity post-discharge care. The programmes were supported by the Ministry of Health in Singapore, which is a city-state nation located in Southeast Asia with a 5.6 million population.ParticipantsLinked healthcare administrative data, for the time period of January 2013 to December 2016, were extracted for patients enrolled in NICE (n=554) or NUHS TCP (n=270) from June 2014 to December 2015, and control patients.InterventionsFor both programmes, teams conducted follow-up home visits and phone calls to monitor and manage patients’ post-discharge.Primary outcome measuresOne-year pre- and post-enrolment healthcare utilisation frequencies and charges of all-cause inpatient admissions, emergency admissions, emergency department attendances, specialist outpatient clinic (SOC) attendances, total inpatient length of stay and mortality rates were compared.ResultsPatients in NICE had lower mortality rate, but higher all-cause inpatient admission, emergency admission and emergency department attendance charges. Patients in NUHS TCP did not have lower mortality rate, but had higher emergency admission and SOC attendance charges.ConclusionsBoth NICE and NUHS TCP had no improvements in 1 year healthcare utilisation across various setting and metrics. Singular interventions might not be as impactful in effecting utilisation without an overhauling transformation and restructuring of the hospital and healthcare system.
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Seidman, Gabriel, Laurie Pascal, and John McDonough. "What benefits do healthcare organisations receive from leadership and management development programmes? A systematic review of the evidence." BMJ Leader 4, no. 1 (February 4, 2020): 21–36. http://dx.doi.org/10.1136/leader-2019-000141.
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IntroductionLeadership and management training/development programmes have gained increasing institutional attention in healthcare organisations, and they have a wide variety of formats and approaches. However, limited evidence exists about effects of these programmes for the organisations that sponsor them. A minority of healthcare systems in the USA measure the impact of these programmes on organisational metrics such as staff turnover or cost savings. This systematic review sought to answer the question, ‘What evidence exists that leadership and/or management development and training programs yield benefits for health care organizations?’ These benefits could include return on investment, improved productivity/cohesion/teaming, or increased use of specific management skills (eg, strategic planning) that would directly benefit the organisation.MethodsWe followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to conduct a systematic review of the relevant literature. We conducted two searches in PubMed and one in ABI/Inform, a business literature database. All articles included for the study were further categorised according to their relevance for answering the research questions, using predefined criteria based on their methodology and reported findings.ResultsOur search included 2462 studies, of which 55 met criteria for inclusion. We identified four potential organisation-level benefits to leadership and management training programmes: benefits to other staff (besides those who participate in the programmes), improved patient safety and satisfaction, tangible benefits from projects that were part of the programme and improved ability/confidence using leadership-related skills by programme participants. However, the research base on this topic is limited.ConclusionAlthough this research identified potential benefits of leadership and management programmes at the organisation level, additional research is needed to make definitive conclusions about their impact.
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Stoller, James K. "Developing physician leaders: does it work?" BMJ Leader 4, no. 1 (March 2020): 1–5. http://dx.doi.org/10.1136/leader-2018-000116.
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BackgroundLeader development programmes are signature features of frontrunner multinational companies. Healthcare institutions have generally lagged behind, though attention to implementing leader development programmes in healthcare institutions is increasing. The rationale for leader development in healthcare is that leadership competencies matter and that traditional selection and training of physicians may conspire against both optimal leadership competencies and followership.MethodsThe growth of leader development in healthcare institutions begs the question: Does leader development work?ResultsIn this context, three meta-analyses have examined the impact of leader development programmes in healthcare institutions. In general, findings from these studies indicate that while studies do assess the subjective learning of participants, few studies have evaluated the organisational impact of such leader development programmes.ConclusionsThese findings suggest the need for more rigorous, objective assessment of the organisational impact of leader development programmes in healthcare institutions. Such evidence is critically needed in the current resource-constrained environment of healthcare.
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Alderson, Sarah, Thomas A. Willis, Su Wood, Fabiana Lorencatto, Jill Francis, Noah Ivers, Jeremy Grimshaw, and Robbie Foy. "Embedded trials within national clinical audit programmes: A qualitative interview study of enablers and barriers." Journal of Health Services Research & Policy 27, no. 1 (December 9, 2021): 50–61. http://dx.doi.org/10.1177/13558196211044321.
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Background Audit and feedback entails systematic documentation of clinical performance based on explicit criteria or standards which is then fed back to professionals in a structured manner. There are potential significant returns on investment from partnerships between existing clinical audit programmes in coordinated programmes of research to test ways of improving the effect of their feedback to drive greater improvements in health care delivery and population outcomes. We explored barriers to and enablers of embedding audit and feedback trials within clinical audit programmes. Methods We purposively recruited participants with varied experience in embedded trials in audit programmes. We conducted qualitative semi-structured interviews, guided by behavioural theory, with researchers, clinical audit programme staff and health care professionals. Recorded interviews were transcribed, and data coded and thematically analysed. Results We interviewed 31 participants (9 feedback researchers, 14 audit staff and 8 healthcare professionals, many having dual roles). We identified barriers and enablers for all 14 theoretical domains but no relationship between domains and participant role. We identified four optimal conditions for sustainable collaboration from the perspectives of stakeholders: resources, that is, recognition that audit programmes need to create capacity to participate in research, and research must be adapted to fit within each programme’s constraints; logistics, namely, that partnerships need to address data sharing and audit quality, while securing research funding to ensure operational success; leadership, that is, enthusiastic and engaged audit programme leaders must motivate their team and engage local stakeholders; and relationships, meaning that trust between researchers and audit programmes must be established over time by identifying shared priorities and meeting each partner’s needs. Conclusion Successfully embedding research within clinical audit programmes is likely to require compromise, logistical expertise, leadership and trusting relationships to overcome perceived risks and fully realise benefits.
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McDonald, Annabel, Jessica A. Eccles, Sanaz Fallahkhair, and Hugo D. Critchley. "Online psychotherapy: trailblazing digital healthcare." BJPsych Bulletin 44, no. 2 (October 7, 2019): 60–66. http://dx.doi.org/10.1192/bjb.2019.66.
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Advances in digital technology have a profound impact on conventional healthcare systems. We examine the trailblazing use of online interventions to enable autonomous psychological care which can greatly enhance individual- and population-level access to services. There is strong evidence supporting online cognitive–behavioural therapy and more engaging programmes are now appearing so as to reduce user ‘attrition’. The next generation of autonomous psychotherapy programmes will implement adaptive and personalised responses, moving beyond impersonalised advice on cognitive and behavioural techniques. This will be a more authentic form of psychotherapy that integrates therapy with the actual relationship experiences of the individual user.
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Lau, Cynthia, and Ben Yuk Fai Fong. "Review of Public Private Partnership in the Health Care in Hong Kong." Asia Pacific Journal of Health Management 16, no. 1 (February 28, 2021): 33–39. http://dx.doi.org/10.24083/apjhm.v16i1.637.
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Public Private Partnership Programme is a cooperation between different healthcare professionals in both public and private sectors. Over the decades, many programmes have been developed which cover various diseases, including chronic conditions and surgery for cataracts, as well as vaccinations. However, these programmes are not successful because of the unsatisfactory service charges to private sector, overlapped aims and resources and wrong estimation of the needs. To become successful, programmes reform is required by rearranging resources, annual reviews, more financial support and extending the coverage of diseases. Promotions are beneficial to all stakeholders. Overall, better coordination between both sectors is the most essential factor which can lead the programme to success and maintain a better health care system in Hong Kong.
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Hartfiel, Ned, John Gladman, Rowan Harwood, and Rhiannon Tudor Edwards. "Social Return on Investment of Home Exercise and Community Referral for People With Early Dementia." Gerontology and Geriatric Medicine 8 (March 2022): 233372142211068. http://dx.doi.org/10.1177/23337214221106839.
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Exercise can improve physical function and slow the progression of dementia. However, uncertainty exists around the costeffectiveness of exercise programmes for people with early dementia. The aim of this study was to determine whether a home-based supervised exercise programme (PrAISED – promoting activity, independence, and stability in early dementia) could generate a positive social return on investment (SROI). SROI analysis was conducted as part of a randomised controlled feasibility trial comparing PrAISED with usual care. Wellbeing valuation was used to compare the costs of the programme with the monetised benefits to participants, carers, and healthcare service providers. The PrAISED programme generated SROI ratios ranging from £3.46 to £5.94 for every £1 invested. Social value was created from improved physical activity, increased confidence, more social connection and PrAISED participants using healthcare services less often than usual care. This study found that home-based supervised exercise programmes could generate a positive SROI for people with early dementia. Trial registration: ClinicalTrials.gov: NCT02874300 (first posted 22 August 2016), ISRCTN: 10,550,694 (date assigned 31 August 2016).
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Ramdzan, Siti Nurkamilla, Ee Ming Khoo, Su May Liew, Steve Cunningham, and Hilary Pinnock. "Stakeholders’ views of supporting asthma management in schools with a school-based asthma programme for primary school children: a qualitative study in Malaysia." BMJ Open 12, no. 2 (February 2022): e052058. http://dx.doi.org/10.1136/bmjopen-2021-052058.
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ObjectiveThe WHO Global School Health Initiative aimed to improve child and community health through health promotion programmes in schools, though most focus on preventing communicable disease. Despite WHO recommendations, no asthma programme is included in the Malaysian national school health service guideline. Therefore, we aimed to explore the views of school staff, healthcare professionals and policy-makers about the challenges of managing asthma in schools and the potential of a school asthma programme for primary school children.DesignA focus group and individual interview qualitative study using purposive sampling of participants to obtain diverse views. Data collection was guided by piloted semistructured topic guides. The focus groups and interviews were audiorecorded, transcribed verbatim and analysed using inductive thematic analysis. We completed data collection once data saturation was reached.SettingStakeholders in education and health sectors in Malaysia.ParticipantsFifty-two participants (40 school staff, 9 healthcare professionals and 3 policy-makers) contributed to nine focus groups and eleven individual interviews.ResultsSchool staff had limited awareness of asthma and what to do in emergencies. There was no guidance on asthma management in government schools, and teachers were unclear about their role in school children’s health. These uncertainties led to delays in the treatment of asthma symptoms/attacks, and suggestions that an asthma education programme and a school plan would improve asthma care. Perceived challenges in conducting school health programmes included a busy school schedule and poor parental participation. A tailored asthma programme in partnerships with schools could facilitate the programme’s adoption and implementation.ConclusionsIdentifying and addressing issues and challenges specific to the school and wider community could facilitate the delivery of a school asthma programme in line with the WHO School Health Initiative. Clarity over national policy on the roles and responsibilities of school staff could support implementation and guide appropriate and prompt response to asthma emergencies in schools.
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White, Nick, Deborah Clark, Robin Lewis, and Wayne Robson. "The Introduction of “Safety Science” into an Undergraduate Nursing Programme at a Large University in the United Kingdom." International Journal of Nursing Education Scholarship 13, no. 1 (January 1, 2016): 11–18. http://dx.doi.org/10.1515/ijnes-2015-0007.
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AbstractImplementing safety science {a term adopted by the authors which incorporates both patient safety and human factors (Sherwood, G. (2011). Integrating quality and safety science in nursing education and practice. Journal of Research in Nursing, 16(3), 226–240. doi: 10.1177/1744987111400960)} into healthcare programmes is a major challenge facing healthcare educators worldwide (National Advisory Group on the Safety of Patients in England, 2013; World Health Organisation, 2009). Patient safety concerns relating to human factors have been well-documented over the years, and the root cause(s) of as many as 65–80 % of these events are linked to human error (Dunn et al., 2007; Reason, 2005). This paper will describe how safety science education was embedded into a pre-registration nursing programme at a large UK university. The authors argue that the processes described in this paper, may be successfully applied to other pre-registration healthcare programmes in addition to nursing.
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Dharmayat, Kanika I. "Sustainability of ‘mHealth’ interventions in sub-Saharan Africa: a stakeholder analysis of an electronic community case management project in Malawi." Malawi Medical Journal 31, no. 3 (September 3, 2019): 177–83. http://dx.doi.org/10.4314/mmj.v31i3.3.
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BackgroundThe global health community and funding agencies are currently engaged in ensuring that worthwhile research-based programmes are sustainable. Despite its importance, few studies have analysed the sustainability of global health interventions. In this paper, we aim to explore barriers and facilitators for the wider implementation and sustainability of a mobile health (mHealth) intervention (Supporting LIFE Community Case Management programme) in Malawi, Africa.MethodsBetween January and March 2017, a qualitative approach was used to carry out and analyse 13 in-depth semi-structured interviews with key stakeholders across all levels of healthcare provision in Malawi to explore their perceptions with regards to the implementation and sustainability of the mHealth programme. Data were analysed thematically by two reviewers. ResultsOverall, our analysis found that the programme was successful in achieving its goals. However, there are many challenges to the wider implementation and sustainability of this programme, including the absence of monetary resources, limited visibility outside the healthcare sector, the lack of integration with community-based and nationwide programmes, services and information and communication technologies, and the limited local capacity in relation to the maintenance, further development, and management.ConclusionsFuture developments should be aligned with the strategic goals and interests of the Ministry of Health and engage with national and international stakeholders to develop shared goals and strategies for nationwide scale-up. These developments should also focus on building local capacity by educating trainers and ensuring that training methods and guidelines are appropriately accredited based on national policies. Our findings provide a framework for a variety of stakeholders who are engaged in sustaining mHealth programmes in resource-poor settings and can be used to develop an evidence-based policy for the utilization of technology for healthcare delivery across developing countries.
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Guha, Chandana, P. Lopez-Vargas, Angela Ju, Talia Gutman, Nicole Jane Scholes-Robertson, Amanda Baumgart, Germaine Wong, et al. "Patient needs and priorities for patient navigator programmes in chronic kidney disease: a workshop report." BMJ Open 10, no. 11 (November 2020): e040617. http://dx.doi.org/10.1136/bmjopen-2020-040617.
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Background and objectivePatients with early chronic kidney disease (CKD) face challenges in accessing healthcare, including delays in diagnosis, fragmented speciality care and lack of tailored education and psychosocial support. Patient navigator programmes have the potential to improve the process of care and outcomes. The objective of this study is to describe the experiences of patients on communication, access of care and self-management and their perspectives on patient navigator programmes in early CKD.Design, setting and participantsWe convened a workshop in Australia with 19 patients with CKD (all stages including CKD Stage 1 to 5 not on dialysis, 5D (dialysis), and 5T (transplant)) and five caregivers. All of them were over 18 years and English-speaking. Transcripts from the workshop were analysed thematically.ResultsFour themes that captured discussions were: lost in the ambiguity of symptoms and management, battling roadblocks while accessing care, emotionally isolated after diagnosis and re-establishing lifestyle and forward planning. Five themes that focussed on patient navigator programmes were: trust and credibility, respecting patient choices and readiness to accept the programme, using accessible language to promote the programme, offering multiple ways to engage and communicate and maintaining confidentiality and privacy. Of the 17 features identified as important for a patient navigator programme, the top five were delivery of education, psychosocial support, lifestyle modification, communication and decision-making support and facilitating care.ConclusionPatient navigator services can address gaps in services around health literacy, communication, psychosocial support and coordination across multiple healthcare settings. In comparison to the existing navigator programmes, and other services that are aimed at addressing these gaps, credible, accessible and flexible patient navigator programmes for patients with early CKD, that support education, decision-making, access to care and self-management designed in partnership with patients, may be more acceptable to patients.
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Ganesh, Shayhana, Renitha Rampersad, and Nirmala Dorasamy. "A Review of Quality Management Systems in South African HIV-AIDS Programmes: A Pre-Requisite for Sustainable Health Delivery." Journal of Economics and Behavioral Studies 9, no. 1(J) (March 12, 2017): 135–40. http://dx.doi.org/10.22610/jebs.v9i1(j).1564.
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The global commitment to end HIV-AIDS is a bold one; requiring a multi-sectoral response strongly embedded within effective HIV-AIDS prevention efforts, patient advocacy and effective healthcare programme delivery. UNAIDS estimates that, of the 36.7 million individuals infected with HIV-AIDS globally, 19.1 million reside in South Africa (UNAIDS Gap report, 2016).In addition, approximately 2.1 million new HIV infections occurred in 2015 with almost 960 000 of those occurring in South Africa signalling that the rates of infections are not dropping as expected (UNAIDS Gap report, 2016). Given the unrelenting nature of this disease burden, even greater efforts are now required to turn the tide on HIV-AIDS globally, but more so in South Africa. These efforts entail more effective HIV-AIDS service delivery with combination prevention modalities, access to HIV-AIDS treatment and care, harm reduction of HIV-AIDS stigma and discrimination together with HIV-AIDS education, awareness and advocacy. Enhancing HIV-AIDS service delivery requires strong commitment with implementation of quality management systems in programme service delivery resulting in sustainable, effective and well run HIV-AIDS programmes. Quality management systems in HIV-AIDS programmes allow programmes to successfully meet their objectives thus allowing optimal patient care through effective and efficient means. To date there has been minimal implementation of quality systems in healthcare especially in South Africa. The use of health quality tools and systems in HIV-AIDS programmes locally and globally will allow for efficient and cost effective benefits for the optimal wellbeing of all those affected and infected by HIV-AIDS. This article reviews available data on the prevalence of quality management systems in HIV-AIDS healthcare and identifies gaps and smart practises towards recommendations for comprehensive global HIV-AIDS standards development.
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Ganesh, Shayhana, Renitha Rampersad, and Nirmala Dorasamy. "A Review of Quality Management Systems in South African HIV-AIDS Programmes: A Pre-Requisite for Sustainable Health Delivery." Journal of Economics and Behavioral Studies 9, no. 1 (March 12, 2017): 135. http://dx.doi.org/10.22610/jebs.v9i1.1564.
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The global commitment to end HIV-AIDS is a bold one; requiring a multi-sectoral response strongly embedded within effective HIV-AIDS prevention efforts, patient advocacy and effective healthcare programme delivery. UNAIDS estimates that, of the 36.7 million individuals infected with HIV-AIDS globally, 19.1 million reside in South Africa (UNAIDS Gap report, 2016).In addition, approximately 2.1 million new HIV infections occurred in 2015 with almost 960 000 of those occurring in South Africa signalling that the rates of infections are not dropping as expected (UNAIDS Gap report, 2016). Given the unrelenting nature of this disease burden, even greater efforts are now required to turn the tide on HIV-AIDS globally, but more so in South Africa. These efforts entail more effective HIV-AIDS service delivery with combination prevention modalities, access to HIV-AIDS treatment and care, harm reduction of HIV-AIDS stigma and discrimination together with HIV-AIDS education, awareness and advocacy. Enhancing HIV-AIDS service delivery requires strong commitment with implementation of quality management systems in programme service delivery resulting in sustainable, effective and well run HIV-AIDS programmes. Quality management systems in HIV-AIDS programmes allow programmes to successfully meet their objectives thus allowing optimal patient care through effective and efficient means. To date there has been minimal implementation of quality systems in healthcare especially in South Africa. The use of health quality tools and systems in HIV-AIDS programmes locally and globally will allow for efficient and cost effective benefits for the optimal wellbeing of all those affected and infected by HIV-AIDS. This article reviews available data on the prevalence of quality management systems in HIV-AIDS healthcare and identifies gaps and smart practises towards recommendations for comprehensive global HIV-AIDS standards development.
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Katz, David A., and H. Gilbert Welch. "Discounting in Cost-Effectiveness Analysis of Healthcare Programmes." PharmacoEconomics 3, no. 4 (April 1993): 276–85. http://dx.doi.org/10.2165/00019053-199303040-00004.
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van Velden, Marieke E., Johan L. Severens, and Annoesjka Novak. "Economic Evaluations of Healthcare Programmes and Decision Making." PharmacoEconomics 23, no. 11 (2005): 1075–82. http://dx.doi.org/10.2165/00019053-200523110-00002.
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Gandjour, Afschin. "Loss Aversion and Cost Effectiveness of Healthcare Programmes." PharmacoEconomics 26, no. 11 (2008): 895–98. http://dx.doi.org/10.2165/00019053-200826110-00001.
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Severens, Johan L. "Loss Aversion and Cost Effectiveness of Healthcare Programmes." PharmacoEconomics 26, no. 11 (2008): 899–900. http://dx.doi.org/10.2165/00019053-200826110-00002.
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Ndetei, David M. "Mental healthcare programmes in Kenya: challenges and opportunities." International Psychiatry 5, no. 2 (April 2008): 31–32. http://dx.doi.org/10.1192/s1749367600005543.
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Lehmann, Uta, Nana A. Y. Twum-Danso, and Jennifer Nyoni. "Towards universal health coverage: what are the system requirements for effective large-scale community health worker programmes?" BMJ Global Health 4, Suppl 9 (October 2019): e001046. http://dx.doi.org/10.1136/bmjgh-2018-001046.
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Against the background of efforts to strengthen health systems for universal health coverage and health equity, many African countries have been relying on lay members of the community, often referred to as community health workers (CHWs), to deliver primary healthcare services. Growing demand and great variability in definitions, roles, governance and funding of CHWs have prompted the need to revisit CHW programmes and provide guidance on the implementation of successful programmes at scale. Drawing on the synthesised evidence from two extensive literature reviews, this article determines foundational elements of functioning CHW programmes, focusing in particular on the systems requirements of large-scale programmes. It makes recommendations for the effective development of large-scale CHW programmes. The key foundational elements of successful CHW programmes identified are (1) embeddedness, connectivity and integration into the larger system of healthcare service delivery; (2) cadre differentiation and role clarity in order to maintain clear scopes of work and accountability; (3) sound programme design based on local contextual factors and effective people management; and (4) ongoing monitoring, learning and adapting based on accurate and timely local data in order to ensure optimal fit to local context since one size does not fit all. We conclude that CHWs are an investment in health systems strengthening and community resilience with enormous potential for contributing to universal health coverage and the sustainable development goals if well designed and managed. While the evidence base is uneven and mixed, it provides extensive insight and knowledge to strengthen, scale up and sustain CHW programmes throughout Africa.
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Peate, Ian. "Bowel cancer screening programme." British Journal of Healthcare Assistants 13, no. 10 (October 2, 2019): 482–85. http://dx.doi.org/10.12968/bjha.2019.13.10.482.
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This article, third in the series concerning screening programmes, considers the bowel cancer screening programme. In the UK, all four countries offer a bowel cancer screening programme to women and men. The overall aim of this screening programme is to check for bowel cancer— or any abnormalities that could lead to bowel cancer. The healthcare assistant and assistant practitioner (HCA and AP) may be required to assist the patient with regards to some aspects of bowel screening. This article provides an overview of the lower gastrointestinal tract and a brief description of signs and symptoms of bowel cancer. There are age differences in Northern Ireland, Wales and England compared to Scotland. The article describes the fundamental principles underpinning bowel cancer screening programmes.
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Bogossian, Aline, Jan Willem Gorter, and Eric Racine. "Protocol for a scoping review about ethics in transition programmes for adolescents and young adults with neurodisabilities." BMJ Open 8, no. 8 (August 2018): e020914. http://dx.doi.org/10.1136/bmjopen-2017-020914.
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IntroductionAs adolescents with neurodisabilities near adulthood, they and their caregivers will face the challenge of transferring from paediatric to adult healthcare systems. Despite the growing number of programmes designed to support healthcare transitions, little is known about practices that result in positive outcomes or how ethical issues are addressed. The objective of this review is to identify and document the ethical principles that may be embedded in the vision of transitional care programmes and to map ethical issues encountered in transitional care as well as the strategies employed to recognise and address these ethical issues.Method and analysisWe will document hidden and explicit ethical principles and issues from empirical studies on transition programmes for youth with neurodisabilities. An initial framework developed through a content extraction strategy will serve as a point of departure for data analysis and will be iteratively refined through our analytic process and with feedback from our stakeholders, including youth with neurodisabilities and their families. Findings will then be shared in different formats with health and social services professionals, healthcare decision and policymakers.DisseminationScoping review results will be shared at key conferences and disseminated in peer-reviewed publications as well as plain language summaries with stakeholders and the general public. Opportunities will be sought to discuss this project and its preliminary findings with partners in the paediatric, adult healthcare and rehabilitation communities comprising young people with neurodisabilities, their families, clinicians, programme managers and researchers.
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Streeton, Ann-Marie, Fleur Kitsell, Munichan Kung, Myint Oo, Vicki Rowse, Viki Wadd, and Harriet Shere. "The Improving Global Health Programme - leadership development in the NHS through overseas placement." BMJ Global Health 6, Suppl 6 (November 2021): e004533. http://dx.doi.org/10.1136/bmjgh-2020-004533.
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The Improving Global Health (IGH) programme develops leadership capacity within the National Health Service (NHS) in a novel way. NHS employees collaboratively run quality improvement projects within organisations in low-income and middle-income countries with whom long-standing healthcare partnerships have been built. Leadership behaviours are developed through theoretical and experiential learning, alongside induction and mentorship. The health systems of overseas partners are strengthened through projects that align with local priorities. This article develops solutions to two main problems: how reciprocal global health programmes can be designed and how global health programmes based in leadership can attract women and black and minority ethnic groups into leadership. The outcomes of both sides of the IGH programme are described here. The overseas perspective is described using the reflections of two current partners, highlighting improvements in the local healthcare system and demonstrating growth in local team members. The UK perspective is evaluated using two surveys sent to different groups of returned IGH participants. Leadership, global health and quality improvement skills improve, having a significant and long-lasting impact on career trajectory. The IGH programme is attracting women and black and minority ethnic groups into leadership. Through collaboration and reciprocity, the IGH programme is developing a new cadre of NHS leader that is diverse and inclusive. The use of long-standing healthcare partnerships ensures that learning is shared and growth is mutual, creating development within the overseas and UK partner alike.
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Theodorakopoulou, Evgenia, Ioannis Goutos, Katrina Mason, Ali M. Ghanem, and Simon Myers. "London calling Gaza: The role of international collaborations in the globalisation of postgraduate burn care education." Scars, Burns & Healing 5 (January 2019): 205951311983051. http://dx.doi.org/10.1177/2059513119830519.
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Burn injuries represent a significant epidemiological problem, with the vast majority occurring in low- to middle-income countries. These regions also represent areas where lack of socioeconomic growth and geopolitical instability pose additional barriers not only to healthcare provision but also to the acquisition of continuing professional development. Long-distance, web-based learning programmes (‘tele-education’) have been identified as a successful and powerful means of propagating up-to-date medical education and training in poor-resource, isolated or conflict-ridden regions. This report evaluates the role of tele-education in delivering a distance-learning Master’s degree in Burn Care to a group of 11 healthcare professionals working in the occupied Palestinian territories (OPT), which was funded as part of a collaboration between Queen Mary University of London and IMET-Pal (International Medical Education Trust – Palestine). We present our experience in delivering the programme in a conflict-ridden part of the world, which includes the specific adaptations to tailor the programme to regional needs as well the unique challenges faced by students and faculty in enhancing the educational value of this unique initiative. The academic achievements of this group of healthcare professionals were found to be comparable to historical student cohorts from privileged socioeconomic backgrounds and the majority of students felt that participation in the programme contributed to a direct improvement to their daily burn care practices. The successful outcomes achieved by our students support the constantly emerging evidence that targeted, well-delivered, long-distance learning programmes can become powerful tools in combating inequalities in global healthcare and health education.
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Brown, Michael, Edward McCann, Gráinne Donohue, Caroline Hollins Martin, and Freda McCormick. "LGBTQ+ Psychosocial Concerns in Nursing and Midwifery Education Programmes: Qualitative Findings from a Mixed-Methods Study." International Journal of Environmental Research and Public Health 18, no. 21 (October 29, 2021): 11366. http://dx.doi.org/10.3390/ijerph182111366.
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LGBTQ+ people experience significant physical and psychosocial health issues and concerns, and encounter barriers when accessing healthcare services. We conducted a mixed-methods research study across all Schools of Nursing and Midwifery in the United Kingdom and Ireland using a survey and qualitative interviews. This was to identify the current content within nursing and midwifery pre-registration programmes in relation to LGBTQ+ health and to identity best practice and education innovation within these programmes. The survey was completed by 29 academics, with 12 selected to participate in a follow-up in-depth qualitative interview. Analysis of the data from the survey and interviews identified five themes: there is variable programme content; academics are developing their own programmes with no clear consistency; LGBTQ+ health is being linked to equality and diversity; there are barriers to education provision; and these is some evidence of best practice examples. The findings of the study support the need to develop and implement a curriculum for LGBTQ+ health in nursing and midwifery pre-registration programmes with learning aims and outcomes. Academics need support and tools to prepare and deliver LGBTQ+ health content to nurses and midwives as they ultimately have the potential to improve the experiences of LGBTQ+ people when accessing healthcare.
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Wild, Cervantée EK, Ngauru T. Rawiri, Esther J. Willing, Paul L. Hofman, and Yvonne C. Anderson. "Determining barriers and facilitators to engagement for families in a family-based, multicomponent healthy lifestyles intervention for children and adolescents: a qualitative study." BMJ Open 10, no. 9 (September 2020): e037152. http://dx.doi.org/10.1136/bmjopen-2020-037152.
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ObjectivesRecruitment and retention in child and adolescent healthy lifestyle intervention services for childhood obesity is challenging, and inequalities across social groups are persistent. This study aimed to understand the barriers and facilitators to engagement in a multicomponent assessment-and-intervention healthy lifestyle programme for children and their families, based in the home and community.DesignQualitative interview-based study of past users (n=76) of a family-based multicomponent healthy lifestyle programme in a mixed urban–rural region of New Zealand. Semistructured, home-based interviews were conducted and thematically analysed with peer debriefing for validity.ParticipantsFamilies were selected through stratified random sampling to include a range of levels of engagement, including those who declined their referral, with equal numbers of interviews with Indigenous and non-Indigenous families.ResultsThree interactive and compounding determinants were identified as influencing engagement in Whānau Pakari: acute and chronic life stressors, societal norms of weight and body size and historical experiences of healthcare. These determinants were present across societal, system and healthcare service levels. A negative referral experience to Whānau Pakari often resulted in participants declining further input or disengaging from the programme. A fourth domain, respectful and compassionate healthcare, was identified as a mitigator of these three themes, facilitating participant engagement despite previous negative experiences.ConclusionsWhile participant engagement in healthy lifestyle programmes is affected by determinants which appear to operate outside immediate service provision, the programme is an opportunity to acknowledge past instances of stigma and the wider challenges of healthy lifestyle change. The experience of the referral to Whānau Pakari is important for setting the scene for future engagement in the programme. Respectful, compassionate care is critical to enhanced retention in multidisciplinary healthy lifestyle programmes and ongoing engagement in healthcare services overall.
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Selroos, Olof, Maciej Kupczyk, Piotr Kuna, Piotr Łacwik, Jean Bousquet, David Brennan, Susanna Palkonen, et al. "National and regional asthma programmes in Europe." European Respiratory Review 24, no. 137 (August 31, 2015): 474–83. http://dx.doi.org/10.1183/16000617.00008114.
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This review presents seven national asthma programmes to support the European Asthma Research and Innovation Partnership in developing strategies to reduce asthma mortality and morbidity across Europe. From published data it appears that in order to influence asthma care, national/regional asthma programmes are more effective than conventional treatment guidelines. An asthma programme should start with the universal commitments of stakeholders at all levels and the programme has to be endorsed by political and governmental bodies. When the national problems have been identified, the goals of the programme have to be clearly defined with measures to evaluate progress. An action plan has to be developed, including defined re-allocation of patients and existing resources, if necessary, between primary care and specialised healthcare units or hospital centres. Patients should be involved in guided self-management education and structured follow-up in relation to disease severity. The three evaluated programmes show that, thanks to rigorous efforts, it is possible to improve patients' quality of life and reduce hospitalisation, asthma mortality, sick leave and disability pensions. The direct and indirect costs, both for the individual patient and for society, can be significantly reduced. The results can form the basis for development of further programme activities in Europe.
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Stenberg, Marie, Elisabeth Mangrio, Mariette Bengtsson, and Elisabeth Carlson. "Formative peer assessment in healthcare education programmes: protocol for a scoping review." BMJ Open 8, no. 11 (November 2018): e025055. http://dx.doi.org/10.1136/bmjopen-2018-025055.
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IntroductionIn formative peer assessment, the students give and receive feedback from each other and expand their knowledge in a social context of interaction and collaboration. The ability to collaborate and communicate are essential parts of the healthcare professionals’ competence and delivery of safe patient care. Thereby, it is of utmost importance to support students with activities fostering these competences during their healthcare education. The aim of the scoping review is to compile research on peer assessment presented in healthcare education programmes, focusing formative assessment. The result of the scoping review will form the basis for developing and conducting an intervention focusing collaborative learning and peer assessment in a healthcare education programme.Methods and analysisThe scoping review will be conducted by using the framework presented by Arksey & O’Malley and Levac et al. The primary research question is: How are formative peer assessment interventions delivered in healthcare education? The literature search will be conducted in the peer-reviewed databases PubMed, Cumulative Index to Nursing and Allied Health Literature, Education Research Complete and Education Research Centre between September and December 2018. Additional search will be performed in Google Scholar, hand-searching of reference lists of included studies and Libsearch for identification of grey literature. Two researchers will independently screen title and abstract. Full-text articles will be screened by three researchers using a charting form. Studies meeting the inclusion criteria will be critically evaluated using the Critical Appraisal Skills Programme. A flow diagram will present the included and excluded studies. A narrative synthesis will be conducted by using thematic analysis as presented by Braun and Clarke. The findings will be presented under thematic headings using a summary table. To enhance validity, stakeholders from healthcare education programmes and healthcare institutions will be provided with an overview of the preliminary results.Ethics and disseminationResearch ethics approval is not required for the scoping review.
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Roberts, Samantha, Eleanor Barry, Dawn Craig, Mara Airoldi, Gwyn Bevan, and Trisha Greenhalgh. "Preventing type 2 diabetes: systematic review of studies of cost-effectiveness of lifestyle programmes and metformin, with and without screening, for pre-diabetes." BMJ Open 7, no. 11 (November 2017): e017184. http://dx.doi.org/10.1136/bmjopen-2017-017184.
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ObjectiveExplore the cost-effectiveness of lifestyle interventions and metformin in reducing subsequent incidence of type 2 diabetes, both alone and in combination with a screening programme to identify high-risk individuals.DesignSystematic review of economic evaluations.Data sources and eligibility criteriaDatabase searches (Embase, Medline, PreMedline, NHS EED) and citation tracking identified economic evaluations of lifestyle interventions or metformin alone or in combination with screening programmes in people at high risk of developing diabetes. The International Society for Pharmaco-economics and Outcomes Research’s Questionnaire to Assess Relevance and Credibility of Modelling Studies for Informing Healthcare Decision Making was used to assess study quality.Results27 studies were included; all had evaluated lifestyle interventions and 12 also evaluated metformin. Primary studies exhibited considerable heterogeneity in definitions of pre-diabetes and intensity and duration of lifestyle programmes. Lifestyle programmes and metformin appeared to be cost effective in preventing diabetes in high-risk individuals (median incremental cost-effectiveness ratios of £7490/quality-adjusted life-year (QALY) and £8428/QALY, respectively) but economic estimates varied widely between studies. Intervention-only programmes were in general more cost effective than programmes that also included a screening component. The longer the period evaluated, the more cost-effective interventions appeared. In the few studies that evaluated other economic considerations, budget impact of prevention programmes was moderate (0.13%–0.2% of total healthcare budget), financial payoffs were delayed (by 9–14 years) and impact on incident cases of diabetes was limited (0.1%–1.6% reduction). There was insufficient evidence to answer the question of (1) whether lifestyle programmes are more cost effective than metformin or (2) whether low-intensity lifestyle interventions are more cost effective than the more intensive lifestyle programmes that were tested in trials.ConclusionsThe economics of preventing diabetes are complex. There is some evidence that diabetes prevention programmes are cost effective, but the evidence base to date provides few clear answers regarding design of prevention programmes because of differences in denominator populations, definitions, interventions and modelling assumptions.
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O'Doherty, Alasdair F., Helen Humphreys, Susan Dawkes, Aynsley Cowie, Sally Hinton, Peter H. Brubaker, Tom Butler, and Simon Nichols. "How has technology been used to deliver cardiac rehabilitation during the COVID-19 pandemic? An international cross-sectional survey of healthcare professionals conducted by the BACPR." BMJ Open 11, no. 4 (April 2021): e046051. http://dx.doi.org/10.1136/bmjopen-2020-046051.
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ObjectiveTo investigate whether exercise-based cardiac rehabilitation services continued during the COVID-19 pandemic and how technology has been used to deliver home-based cardiac rehabilitation.DesignA mixed methods survey including questions about exercise-based cardiac rehabilitation service provision, programme diversity, patient complexity, technology use, barriers to using technology, and safety.SettingInternational survey of exercise-based cardiac rehabilitation programmes.ParticipantsHealthcare professionals working in exercise-based cardiac rehabilitation programmes worldwide.Main outcome measuresThe proportion of programmes that continued providing exercise-based cardiac rehabilitation and which technologies had been used to deliver home-based cardiac rehabilitation.ResultsThree hundred and thirty eligible responses were received; 89.7% were from the UK. Approximately half (49.3%) of respondents reported that cardiac rehabilitation programmes were suspended due to COVID-19. Of programmes that continued, 25.8% used technology before the COVID-19 pandemic. Programmes typically started using technology within 19 days of COVID-19 becoming a pandemic. 48.8% did not provide cardiac rehabilitation to high-risk patients, telephone was most commonly used to deliver cardiac rehabilitation, and some centres used sophisticated technology such as teleconferencing.ConclusionsThe rapid adoption of technology into standard practice is promising and may improve access to, and participation in, exercise-based cardiac rehabilitation beyond COVID-19. However, the exclusion of certain patient groups and programme suspension could worsen clinical symptoms and well-being, and increase hospital admissions. Refinement of current practices, with a focus on improving inclusivity and addressing safety concerns around exercise support to high-risk patients, may be needed.
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Bekomsom, Emmanuel M., James A. Ogar, Abayomi I. Akintola, Emmanuella Dike, Tangban Egbe, Francis E. Ibioro, and Adeolu Ayodele. "Improving the Wellbeing of Ikot Ene During the COVID-19 Lockdown: The Role of Justice, Development and Peace/Caritas Advocates (JDPCA)." Daengku: Journal of Humanities and Social Sciences Innovation 1, no. 1 (April 5, 2021): 40–47. http://dx.doi.org/10.35877/454ri.daengku413.
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The study's objective is to examine the relationship between Justice, Development and Peace/Caritas Advocates (JDPCA) activities and the Wellbeing of Ikot Ene people during COVID-19 Lockdown. Specifically, the study examines the relationship between JDPCA’s provision of palliatives, healthcare programmes, and the Wellbeing of Ikot Ene people during COVID-19 Lockdown. Two research questions and null hypotheses were raised for the study. Literature was reviewed according to the variables of the study. The survey research design was adopted in collecting data from 176 samples from a population of 725 beneficiaries of the JDPCA programme from Ikot Ene in Akpabuyo Local government Area of Cross River state. The instrument of data collection was the question. Data collected from the field was analyzed using descriptive and inferential statistics. Result revealed a correlation between JDPCA’s provision of palliatives; healthcare programmes had a significant impact on the Wellbeing of the people of Ikot Ene. During COVID-19 Lockdown. Based on the study's findings, the study recommends a need for the Justice, Development and Peace/Caritas Advocates (JDPCA) to improve their coverage area and the number of beneficiaries for their future programmes.
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Ezika, Ejiofor Augustine, Beth Cross, and Moira Lewitt. "Sources of Cardiovascular Health Information and Channels of Health Communication among Urban Population in Nigeria." International Journal of Public Health Science (IJPHS) 7, no. 1 (March 1, 2018): 72. http://dx.doi.org/10.11591/ijphs.v7i1.10767.
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<p>This study employed mixed methods to investigate the preferred sources of health information and later explored the views of community healthcare workers on the enablers, barriers and ways of overcoming barriers to health communication. The study found that majority of the participants preferred their source of CV (cardiovascular) health information from the healthcare workers including the medical doctors, nurses, and pharmacists. On the other hand, the least preferred source of health information was from friends, family members, and community leaders. Some of the identified enablers to community health communication include awareness programme via Non-Governmental Organisations (NGOs), community-based organisations such as faith-based organisations and healthcare facilities. Others are traditional media and social media. The identified barriers to community-based health communication include lack of knowledge and poverty, language barriers, and other miscellaneous issues including misuse of internet, lack of basic amenities and religious beliefs. The community-based healthcare providers articulated ways to overcome the identified barriers, including enlightenment programmes, using the language of the target audience, funding health awareness programmes, and monitoring of health education interventions. This study concludes that dissemination of health information using numerous channels is essential in ensuring population-wide primary prevention of diseases.</p>
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Buchman, Daniel Z., Aaron M. Orkin, Carol Strike, and Ross E. G. Upshur. "Overdose Education and Naloxone Distribution Programmes and the Ethics of Task Shifting." Public Health Ethics 11, no. 2 (February 3, 2018): 151–64. http://dx.doi.org/10.1093/phe/phy001.
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Abstract North America is in the grips of an epidemic of opioid-related poisonings. Overdose education and naloxone distribution (OEND) programmes emerged as an option for structurally vulnerable populations who could not or would not access mainstream emergency medical services in the event of an overdose. These task shifting programmes utilize lay persons to deliver opioid resuscitation in the context of longstanding stigmatization and marginalization from mainstream healthcare services. OEND programmes exist at the intersection of harm reduction and emergency services. One goal of OEND programmes is to help redress the health-related inequities common among people who use drugs, which include minimizing the gap between people who use drugs and the formal healthcare system. However, if this goal is not achieved these inequities may be entrenched. In this article, we consider the ethical promises and perils associated with OEND as task shifting. We argue that public health practitioners must consider the ethical aspects of task shifting programmes that may inadvertently harm already structurally vulnerable populations. We believe that even if OEND programmes reduce opioid-related deaths, we nevertheless question if, by virtue of its existence, OEND programmes might also unintentionally disenfranchise structurally vulnerable populations from comprehensive healthcare services, including mainstream emergency care.
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Holloway, Samantha, Ann Taylor, and Michal Tombs. "Impact of postgraduate study on healthcare professionals' academic and clinical practice." British Journal of Healthcare Management 26, no. 7 (July 2, 2020): 171–78. http://dx.doi.org/10.12968/bjhc.2019.0058.
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Aims/Background Existing literature in the healthcare setting indicates that individuals enter higher education, particularly postgraduate programmes, to gain in-depth knowledge of a subject area, with a view to improving their career opportunities. Evidence also suggests that, in addition to perceived career enhancement, individuals also report benefits such as personal growth and broadening of perspectives, which have helped their clinical practice. The aim of this study was to examine the impact of postgraduate study on healthcare professionals' academic practice and discuss the potential links to improvements in clinical practice. Method This was a descriptive cross-sectional survey of a convenience sample of graduates from a range of postgraduate healthcare programmes at one UK university. A survey comprising 18 questions was designed to explore perceptions of impact and was distributed to 962 graduates with a response rate of 9.81% (n=98). Results The majority of respondents were doctors (n=54, 55.1%), women (n=59, 60.2%), based within the UK (n=36, 36.7%) and had completed their programme between 2014 and 2016 (n=72, 73.4%). With regards to achievements in professional practice, participants felt more confident in relation to research and evaluating evidence. In relation to impact on clinical practice, improvements in multidisciplinary team working as well as increased confidence emerged as main themes. Conclusions Findings support existing evidence in relation to the importance of postgraduate study, which is able to instil an increased sense of confidence in graduates' ability. This was particularly related to having a better understanding of speciality-related evidence and its application in clinical practice. This is something that previous studies do not seem to have reported and may reflect the multiprofessional nature of many of the postgraduate programmes provided.
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Frich, Jan C., and Ivan Spehar. "Physician leadership development: towards multidisciplinary programs?" BMJ Leader 2, no. 3 (August 7, 2018): 91–94. http://dx.doi.org/10.1136/leader-2018-000070.
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BackgroundThe format and content of leadership development programmes for physicians is a theme for discussion in the literature.ObjectivesThe aim of this study is to explore healthcare executives’ perspectives on physician leadership development, focusing on perceived benefits and negative effects associated with multidisciplinary programmes.MethodsWe did a qualitative study based on data from semistructured interviews with 16 healthcare executives in US healthcare systems.ResultsWe found that one group perceived programmes targeting one profession as advantageous, promoting openness and professional relationships among peers. Other executives argued that multidisciplinary programmes could add value because they could bridge professional boundaries, strengthen networks and build leadership capacity throughout an organisation. Costs, timing, organisational culture and a lack of knowledge about how to run multidisciplinary programmes were challenges our informants associated with multidisciplinary leadership development programmes.ConclusionThis study identifies topics and challenges that can inform organisational policies and decisions about leadership development activities.
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Ögmundsdottir Michelsen, Halldora, Ingela Sjölin, Mona Schlyter, Emil Hagström, Anna Kiessling, Peter Henriksson, Claes Held, et al. "Cardiac rehabilitation after acute myocardial infarction in Sweden – evaluation of programme characteristics and adherence to European guidelines: The Perfect Cardiac Rehabilitation (Perfect-CR) study." European Journal of Preventive Cardiology 27, no. 1 (July 26, 2019): 18–27. http://dx.doi.org/10.1177/2047487319865729.
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Background While patient performance after participating in cardiac rehabilitation programmes after acute myocardial infarction is regularly reported through registry and survey data, information on cardiac rehabilitation programme characteristics is less well described. Aim The aim of this study was to evaluate Swedish cardiac rehabilitation programme characteristics and adherence to European Guidelines on Cardiovascular Disease Prevention. Method Cardiac rehabilitation programme characteristics at all 78 cardiac rehabilitation centres in Sweden in 2016 were surveyed using a web-based questionnaire (100% response rate). The questions were based on core components of cardiac rehabilitation as recommended by European Guidelines. Results There was a wide variation in programme duration (2–14 months). All programmes reported offering an individual post-discharge visit with a nurse, and 90% ( n = 70) did so within three weeks from discharge. Most programmes offered centre-based exercise training ( n = 76, 97%) and group educational sessions ( n = 61, 78%). All programmes reported to the national audit, SWEDEHEART, and 60% ( n = 47) reported that performance was regularly assessed using audit data, to improve quality of care. Ninety-six per cent ( n = 75) had a core team consisting of a cardiologist, a physiotherapist and a nurse and 76% ( n = 59) reported having a medical director. Having other allied healthcare professionals included in the cardiac rehabilitation team varied. Forty per cent ( n = 31) reported having regular team meetings where nurses, physiotherapists and cardiologist could discuss patient cases. Conclusion The overall quality of cardiac rehabilitation programmes provided in Sweden is high. Still, there are several areas of potential improvement. Monitoring programme characteristics as well as patient outcomes might improve programme quality and patient outcomes both at a local and a national level.