Artykuły w czasopismach na temat „Client staff”
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Pino, Marco. "Delivering criticism through anecdotes in interaction". Discourse Studies 18, nr 6 (6.10.2016): 695–715. http://dx.doi.org/10.1177/1461445616668069.
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Criticising someone’s conduct is a disaffiliative action that can attract recipient objections, particularly in the form of defensive detailing by which the recipient volunteers extenuating circumstances that undermine the criticism. In Therapeutic Community (TC) meetings for clients with drug addiction, support staff regularly criticise clients’ behaviours that violate therapeutic principles or norms of conduct. This study examines cases where, rather than criticising a client’s behaviour directly, TC staff members do so indirectly through an anecdote: a case illustrating the inappropriateness of the type of conduct of which the client’s behaviour is an instantiation. TC staff members design the anecdote to convey a principle or norm of conduct which the client has putatively violated, and they systematically pursue endorsement of that principle by the client. By constructing the anecdote as an exemplary case, distanced from the individual client’s personal experience, TC staff members make it an empirically unverifiable, self-evident, and therefore hard to challenge, illustration of a norm.
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Saxby, Helen, David Felce, Martin Harman i Alan Repp. "The Maintenance of Client Activity and Staff–Client Interaction in Small Community Houses for Severely and Profoundly Mentally Handicapped Adults: A Two-Year Follow-Up". Behavioural and Cognitive Psychotherapy 16, nr 3 (lipiec 1988): 189–206. http://dx.doi.org/10.1017/s0141347300013641.
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In a previous study (Felce, de Kock and Repp, 1986), appropriate client activity was found to be considerably higher in two community homes for severely and profoundly mentally handicapped adults than in a number of institutions. Client activity was also shown to be related to the extent of staff interaction. The method of this study was replicated in a two-year follow-up to investigate whether these desirable levels of staff interaction and client activity were maintained. Client engagement in appropriate activity remained similar for five subjects but had fallen slightly for a further five. The duration of instruction given to the majority of subjects by staff had declined but so too, for a variety of reasons, had staff–client ratios. Overall, the follow-up data give a general impression of the maintenance of client activity with some subjects engaging with greater independence. However, interpretation is dependent on the role that staff–client ratio may play in determining staff performance and in particular their level of interaction with clients.
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Walz, Linda T., i Laura H. Goldstein. "The Mental Impairment and Evaluation Treatment Service: staff attitudes and staff–client interactions". Psychological Medicine 22, nr 2 (maj 1992): 503–11. http://dx.doi.org/10.1017/s0033291700030440.
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SYNOPSISThis study describes and evaluates a new short-term residential service for adults with mild learning difficulties and challenging behaviour, the Mental Impairment Evaluation and Treatment Service. The study examines staff attitudes towards management practices, towards the potential achievement of individuals with learning difficulties, the staff's perceived involvement in decision making, and also the nature of their interaction with the clients, in two different settings on the Unit. The Unit's management practices were found to be client-orientated in nature and staff were more in agreement with client-orientated than institution-orientated management practices. Staff were generally optimistic about clients' potential and felt involved in decision making. Correlations between certain staff characteristics, attitudes and interactions are discussed. The study extends the range of services that have been evaluated in this way, and provides a description of the service in its early stages, which will provide an important comparison point for it when it is more permanently established.
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Broerse, Jora. "“How Do We Put Him in the System?”: Client Construction at a Sport-Based Migrant Settlement Service in Melbourne, Australia". Social Inclusion 7, nr 1 (28.02.2019): 238–47. http://dx.doi.org/10.17645/si.v7i1.1803.
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The empirical focus of this article is a sport-based settlement service targeting newly arrived migrants in Melbourne, Australia. This five-month study examines staff members’ everyday work routines with a focus on their participation in meetings and the production of documents. Embedded in the Australian immigration policy context, this article shows how staff members aim to empower clients while simultaneously falling back into stigmatising refugee/client identification through administrative practices. The results indicate that staffs’ everyday client constructions reinforce the othering and categorisation of ethnic minorities and support a reductionist deficit model of presenting clients. This may limit the opportunities for migrants to identify with and participate in wider Australian society and thus has the opposite effect of what governments and the sector aim to accomplish.
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Clark, Carrie, Elizabeth Scott i Terry Krupa. "Involving Clients in Programme Evaluation and Research: A New Methodology for Occupational Therapy". Canadian Journal of Occupational Therapy 60, nr 4 (październik 1993): 192–99. http://dx.doi.org/10.1177/000841749306000405.
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Eliciting client satisfaction with services has become common in mental health settings and in the planning of service delivery systems. It is also compatible with the client-centred practice of occupational therapy. The traditional approach to collecting satisfaction information involves staff interviewing clients using questionnaires developed by staff. However, there is often a lack of variability in responses and the vast majority of clients report being satisfied. A review of the literature reveals that these favourable reports may be a result of social desirability and of clients being interviewed by treatment providers who have the power to give or withhold care. This paper reviews the relationship between occupational therapy and client involvement, examines the rationale for involving clients in programme evaluation and research, reviews the limitations with traditional methods of collecting information about client satisfaction, and discusses how clients are involved in evaluation and research in today's mental health care setting.
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Rege, Swapnil, Aisha Mian Malik, Marybeth Ward i Jing Hong. "Checklists in community care: reducing differences in care delivery between regular and relief staff to improve consistency and client experience". BMJ Open Quality 9, nr 2 (czerwiec 2020): e000809. http://dx.doi.org/10.1136/bmjoq-2019-000809.
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BackgroundToday, healthcare is more complex than just ensuring clients receive quality care; it also involves consistently delivering excellent client experience. A non-profit community support services agency conducted an extensive diagnostic journey to determine root causes of inconsistent care delivery between regular and relief frontline staff.Local problemClients and family caregivers noted lower satisfaction in care delivery when a relief staff (ie, internal staff or an external agency that is covering a shift) provided service in comparison with their regular staff. The diagnostic journey discovered that the shift exchange process—when outgoing staff transfers critical knowledge to incoming staff for continuing care—varied significantly between the 11 service locations, leading to a lack of consistent service delivery, thereby impacting client experience.MethodsA working group consisting of Supervisors of Client Services, Personal Support Workers (PSW) and management were tasked with process mapping the current state, highlighting gaps and outlining the ideal state of the shift exchange process.InterventionsUsing best practices from the aviation industry, a checklist was developed that encapsulated all the critical steps needed to be undertaken for a successful, consistent shift exchange. The theory was that the utilisation of the checklist would enable consistency and improve client satisfaction with care delivery, especially when care is delivered by a staff unfamiliar with clients.ResultsPrior to the checklist implementation, 74% of clients were satisfied or very satisfied with their relief staff, and post checklist implementation client satisfaction improved to 90%. Staff self-assessments also indicated that PSWs agreed that the checklist helped provide consistent care.ConclusionThe use of checklists can transform the way care is delivered in the community support sector and other service delivery agencies alike to bring greater standardisation of care between providers, thus significantly improving client experience across the healthcare sector.
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Crocker, Peter J., i Margo S. George. "Participation and Utilization: Assessing the Skills Training Needs of the Chronically Mentally Ill". Canadian Journal of Community Mental Health 4, nr 2 (1.09.1985): 73–82. http://dx.doi.org/10.7870/cjcmh-1985-0016.
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Utilization-focused and stakeholder-based approaches to evaluation attempt to enhance utilization through the participation of individuals with a vested interest in evaluation outcomes. The present study sought to determine the skills training needs of the chronically mentally ill, and involved program participants (clients and staff) in measurement and design issues. Client interview, nominal group, and key informant strategies were used to obtain a variety of perspectives on client needs. Program clients were given a voice in decision-making and program planning, and research results were used to develop a skills training program relevant to client's needs.
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Molina, Julian. "Intervention Tales: Talk, Documents, and “Engagement” on a Wage Subsidy Project". Qualitative Sociology Review 14, nr 1 (15.03.2018): 68–82. http://dx.doi.org/10.18778/1733-8077.14.1.04.
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Drawing from ethnographic fieldwork on a wage subsidy project for NEETs in London, this article examines how talk and documents are used to make sense of caseloads and clients. The article draws attention to the way that staff account for clients through using “Intervention Tales.” The use of these tales provide insights into the routine implementation of labor market interventions. The article describes the work involved in documenting staff-client interactions and selecting which clients to put forward for “live vacancies.” The article shows how organizational documents, spreadsheets, and client registration forms are used as resources for assessing “hard to engage” clients during routine activities. In this sense, intervention tales, talk, and documents provide practical resources for organizing ordinary activities, such as segmenting client caseloads and characterizing individual clients.
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Wilkinson, Joanne, Nechama W. Greenwood, Claire Tienwey Wang, Laura F. White i Larry Culpepper. "Measuring Staff Empowerment Regarding Health Care for Clients with Intellectual Disabilities". International Journal of Family Medicine 2014 (25.02.2014): 1–6. http://dx.doi.org/10.1155/2014/678127.
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Background. Women with intellectual disabilities (ID) contract breast cancer at the same rate as the general population but have higher breast cancer mortality and lower rates of breast cancer screening. Many women with ID live in group homes or supported residences where they are cared for by direct support workers. While direct support workers are thought to influence client health, this effect is underresearched, and we lack tools for measuring staff empowerment and perceptions regarding client health. Methods. We developed and validated an instrument, the staff empowerment tool (SET), to measure staff empowerment as related to supporting clients in preventive health. Results. The SET was found to be a reliable instrument for measuring staff activation and empowerment in helping clients access mammography screening. Discussion. Quantifying staff empowerment and perspectives is important in studying and reducing disparities among adults with ID, a vulnerable population. Further research to determine the impact of staff empowerment levels on their clients’ health and health care access is suggested. The SET is a valuable tool for measuring the construct of staff empowerment, evaluating interventions, and collecting data regarding variation in staff empowerment.
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Van der Meulen, Anne Pier S., Maaike A. Hermsen i Petri JCM Embregts. "Restraints in daily care for people with moderate intellectual disabilities". Nursing Ethics 25, nr 1 (4.04.2016): 54–68. http://dx.doi.org/10.1177/0969733016638141.
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Background: Self-determination is an important factor in improving the quality of life of people with moderate intellectual disabilities. A focus on self-determination implies that restraints on the freedom of people with intellectual disabilities should be decreased. In addition, according to the Dutch Care and Coercion bill, regular restraints of freedom, such as restrictions on choice of food or whom to visit, should be discouraged. Such restraints are only allowed if there is the threat of serious harm for the clients or their surroundings. Research question: What do support staff consider as restraints on freedom and how do they justify these restraints? Research design: In this study, data were collected by semi-structured interviews. Participants and research context: Fifteen support staff working with clients with moderate intellectual disabilities were interviewed. All participants work within the same organisation for people with intellectual disabilities in the Eastern part of the Netherlands. Ethical considerations: The study was conducted according to good scientific inquiry guidelines and ethical approval was obtained from a university ethics committee. Findings: Most restraints of freedom were found to be centred around the basic elements in the life of the client, such as eating, drinking and sleeping. In justifying these restraints, support staff said that it was necessary to give clarity in what clients are supposed to do, to structure their life and to keep them from danger. Discussion: In the justification of restraints of freedom two ethical viewpoints, a principle-guided approach and an ethics of care approach, are opposing one other. Here, the self-determination theory can be helpful, while it combines the autonomy of the client, relatedness to others and the client’s competence. Conclusion: Despite the reasonable grounds support staff gave for restraining, it raises the question whether restraints of freedom are always in the interest of the client.
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Rahim, Syamsuri, Hamzah Ahmad, Nurwakia Nurwakia, Nurfadila Nurfadila i Muslim Muslim. "The Influence of Audit Staff Quality and Client Type on Audit Evidence Collection with Communication Type as Moderation". Journal of Accounting and Strategic Finance 3, nr 1 (16.06.2020): 103–17. http://dx.doi.org/10.33005/jasf.v3i1.79.
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This study aims to examine the effect of audit staff quality (staff in-charge or auditors who carry out audit tasks) and the client type on the audit evidence collection is moderated by the communication type. The study population was auditors working in the Makassar Public Accounting Firm. The sampling technique used was purposive sampling, while the data collection was done by distributing questionnaires to all auditors who met the sample criteria. The samples are thirty-three auditors from seven public accountant office in Makassar city. The hypothesis test was conducted using Smart PLS 3. This study found that the audit staff quality, client type, and communication type had a positive effect on the collection of audit evidence directly. Furthermore, the moderation test results found that the communication type strengthens the relationship between the client type and the collection of audit evidence. It means that while gathering audit evidence, the higher the audit staff quality, the more evidence they can obtain. The same result also found in the relationship between the client type and the audit evidence collection. When the client type is friendly, the more audit evidence is gathered. Based on these results, it is suggested that junior auditor must build their confidence in dealing with the clients.
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Shelton, David. "Client Sexual Behaviour and Staff Attitudes". Journal of the British Institute of Mental Handicap (APEX) 20, nr 2 (26.08.2009): 81–84. http://dx.doi.org/10.1111/j.1468-3156.1992.tb00664.x.
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Kuipers, Elizabeth, i Estelle Moore. "Expressed Emotion and Staff-Client Relationships". International Journal of Mental Health 24, nr 3 (wrzesień 1995): 13–26. http://dx.doi.org/10.1080/00207411.1995.11449316.
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Brigham, Christopher R. "Common Tips for IMEs (Part 1): Perfecting the IME Process". Guides Newsletter 5, nr 5 (1.09.2000): 6–7. http://dx.doi.org/10.1001/amaguidesnewsletters.2000.sepoct05.
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Abstract The pre-evaluation phase of an independent medical evaluation (IME) consists of several steps that lead to the evaluation itself. A table lists typical issues and tasks facing independent medical evaluators. The evaluation begins when the client requests an IME, and the scope of issues depends on the case's specifics and setting. The evaluating physician must understand the client's expectations and the nature of the evaluation, and specialists in the same field as the treating physician often perform the evaluation. Clients usually are responsible for obtaining medical records and other documentation. At the time of referral, the client is given the date and the time of the evaluation. Analysis of medical records is essential. Often, records provided by a client are disorganized or incomplete, and staff members can develop lists of records provided, identify missing items, and contact the client to obtain them. Staff also should notify the physician before particularly complex evaluations so the physician can allocate adequate time for a detailed review. Issues and deficiencies typically encountered in IMEs include the following: inadequate objective foundations for diagnoses and conclusions, undocumented findings, use of tests that lack validity and reliability, presence or absence of nonphysiologic and behavioral findings, and unsupported conclusions.
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Ayres, Leah, Lindi Pelkowitz, Perlin Simon i Sandra C. Thompson. "Necessity as the Catalyst of Change: Exploring Client and Provider Perspectives of Accelerated Implementation of Telehealth by a Regional Australian Community Service Organisation during COVID-19 Restrictions". International Journal of Environmental Research and Public Health 18, nr 21 (30.10.2021): 11433. http://dx.doi.org/10.3390/ijerph182111433.
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Community services have played a significant role in supporting the psychosocial health and well-being of vulnerable populations during the SARS-CoV-2 (COVID-19) pandemic. To meet increased community needs, organisations were required to rapidly modify service provision, often using remote delivery systems. This in-depth study, undertaken early in the pandemic, explored staff and clients’ experiences of adapting to using telehealth to provide and access services in one regional social services agency. Semi-structured interviews from 15 staff and 11 clients from a regional not-for-profit agency in Western Australia were recorded and transcribed. Inductive coding, and thematic analysis identified eight subthemes, with experiences and perceptions of telehealth varying substantially among staff and client groups. Distinct benefits and challenges were associated with telehealth. Participants highlighted tensions and complexities and commented on the place of telehealth in the community service sector. Clients expressed the importance of relationships and communication. This study provides in-depth insights into the contextualised experiences of staff and clients during a time at which change was both enabled and necessary. The findings highlight the need for tailored service delivery; choice; client collaboration; ongoing staff training relating to telehealth; and guidelines specific to telehealth in the community service sector.
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Darkwa, Maame, Katrina Engel, Zoe Findlay, Anne-Marie Voyer i Andrea E. Waddell. "Using co-design to improve the client waiting experience at an outpatient mental health clinic". BMJ Open Quality 12, nr 1 (styczeń 2023): e001781. http://dx.doi.org/10.1136/bmjoq-2021-001781.
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Prolonged wait times in healthcare are a complex issue that can negatively impact both clients and staff. Longer wait times are often caused by a number of factors such as overly complicated scheduling, inefficient use of resources, extraneous processes, and misalignment of supply and demand. Growing evidence suggests a correlation between wait times and client satisfaction. This relationship, however, is complex. Some research suggests that client satisfaction with wait times may be improved with interventions that enhance the waiting experience and not actual wait times. This project aimed to improve the average daily rating of the client waiting experience by 1 point on a 7-point Likert scale.A quality improvement study was conducted to analyse client satisfaction with wait times and enhance clients’ satisfaction while waiting. Quality improvement methods, mainly co-design sessions, were used to co-create and implement an intervention to improve clients’ experience with waiting in the clinic.The project resulted in the implementation of a whiteboard intervention in the clinic to inform clients where they are in the queue. The whiteboard also included static data summarising the average wait times from the previous month. Both aspects of the whiteboard were designed to allow patients to better approximate their wait times. Though the quantitative analysis did not reveal a 1-point improvement on a 7-point Likert scale, the feedback from staff and clients was positive. Since implementation, clinic staff and management have developed the intervention into a high-fidelity digital board that is still in use today. Furthermore, the use of the intervention has been extended locally, with additional ambulatory clinics at the hospital planning to use the set-up in their clinic waiting rooms.
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Mik-Meyer, Nanna. "Identities and Organisations. Evaluating the Personality Traits of Clients in Two Danish Rehabilitation Organizations". Outlines. Critical Practice Studies 8, nr 1 (16.04.2006): 32–48. http://dx.doi.org/10.7146/ocps.v8i1.2097.
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This article explores how the guidelines for personality assessments in two Danish rehabilitation organizations influence the actual evaluation of clients. The analysis shows how staff members produce institutional identities corresponding to organizational categories, which very often have little or no relevance for the clients evaluated. The goal of the article is to demonstrate how the institutional complex that frames the work of the organizations produces the client types pertaining to that organization. The rehabilitation organizations’ local history, legislation, along with the structural features of the labour market and social work result in a number of contradictions that make it difficult to deliver client-centred care. According to the staff, this is one of the most important aims of “good” social work.
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Woodhouse, Abbie, i Sarah Craven-Staines. "A systematic review exploring the role of gender in staffs experience of working with sexual offenders". Journal of Criminological Research, Policy and Practice 7, nr 4 (13.10.2021): 373–83. http://dx.doi.org/10.1108/jcrpp-04-2021-0018.
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Purpose Although literature surrounding sexual criminality is growing; with recent research, this paper aims to focus more upon burnout and emotional impact in therapists who study with sex offenders, little is known about possible gender differences in their experiences. Design/methodology/approach The study presents a systematic review that aims to provide an impartial critical examination of relevant existing literature, with the main aim of exploring the role of gender (both the staff members and the clients) in staffs’ experience of working with sexual offenders. Findings Findings retrieved 10 eligible studies indicating evidence of the influential role in which gender plays in the experienced staff may have when working with sexual offenders. Studies within the review demonstrated variability in views towards sexual offenders across genders; with studies finding female staff to hold more positive perceptions of sexual offenders. Further evidence suggested a global impact of working with the client group; with professionals holding differential and largely more positive views of sexual offenders than the general public. However, an adverse impact of working with sexual offenders was highlighted, particularly for staff who have worked longest within their role or have increased frequency of contact. Research limitations/implications Limitations were highlighted in relation to the reviews ability to truly explore gender; given there are no current studies within this research area defining gender beyond male and female, losing the voices of those non-binary and transgendered individuals. Practical implications The paper includes implications for staff working with sexual offenders; including adverse affects of the clinical contact and the impact of working with same/opposing gendered clients. Research also takes a gender informed stance in exploring how staff gender impacts the relationships with sexual offenders, and the effect this may have on client outcomes. Originality/value Research is the first of its kind in taking a systematic approach to exploring the current literature surrounding staffs experiences of working with sexual offenders, through a gender informed lens.
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Browning, Mary, i Robert Jones. "Using Staff Ratings to Measure Client Compatibility". Journal of Learning Disabilities 6, nr 1 (marzec 2002): 35–46. http://dx.doi.org/10.1177/146900470200600103.
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Worthington, Rachel. "What are the key skills that staff require to support adults on the autism spectrum effectively?" Forensic Update 1, nr 123 (grudzień 2016): 15–23. http://dx.doi.org/10.53841/bpsfu.2016.1.123.15.
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The paper will begin by defining autism and the associated presentations of clients with this diagnosis. It will then explore what skills have been found to be helpful for staff working with this client group. The paper will identify that whilst there is some guidance on what skills may be helpful when selecting staff to work with this client group, however, much of this is based on opinion rather than research. What is evident is that some of the skills discussed are those which can be learned or taught and these will be discussed. The paper will make suggestions for the ways in which future research could be developed.
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Lichtenstein, Bronwen, i Laura H. Bachmann. "Staff Affirmations and Client Criticisms: Staff and Client Perceptions of Quality of Care at Sexually Transmitted Disease Clinics". Sexually Transmitted Diseases 32, nr 5 (maj 2005): 281–85. http://dx.doi.org/10.1097/01.olq.0000163597.44078.19.
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Arco, Lucius. "Using Self-generated Feedback for Generalising and Maintaining Staff Performance in a Rehabilitation Program". Behaviour Change 19, nr 2 (1.06.2002): 75–89. http://dx.doi.org/10.1375/bech.19.2.75.
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AbstractThe aim of this study was to examine whether a low cost self-generated feedback procedure was sufficient for generalising and maintaining staff performance. Two staff members were trained to implement a communication skills program with a client with severe closed head injuries. Staff were first trained to perform competently via written instructions, videotaped models, discussion, and on-the-job supervisory feedback. Posttraining conditions consisted of staff continuing with recording and graphing gains in client skills, or rating their own performance (i.e., they continued with self-generated feedback). A multiple baseline design across client skills and staff was used to observe generalised effects on staff performance (prompts and positive consequences) and client skills. Results show that after staff attained competency, and without further supervisory feedback, their performance generalised to topographically similar performance, and the staff member who consistently participated in the study maintained her performance for 16 weeks.
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Allie, Samina, i Suzanne Whittall. "Using narratives on an acute psychiatric ward". Counselling Psychology Review 26, nr 3 (wrzesień 2011): 34–44. http://dx.doi.org/10.53841/bpscpr.2011.26.3.34.
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BackgroundMental health professionals are looking at more ways in which clients’ voices can be heard throughout their treatment. One of the ideas being suggested is through narratives. Narratives are a way people can derive meaning from events by retelling their story putting their experience in chronological order. The 2002 NICE Guidelines also suggest encouraging clients to write their own accounts of their admission to hospital. This service evaluation discusses the idea of using narratives in inpatient care and evaluates how useful it has been for both staff and patients to be involved in the narrative process. Our main aims in introducing the ‘Narrative Project’ (the ‘Project’) were to determine if the process of creating a narrative impacted upon therapeutic relationships between staff and clients, whether narratives could improve client’s insight and if the process could improve Staff confidence in their skills.MethodQuestionnaires were used to determine if the aims of our ‘Narrative Project’ were being met. The findings of the questionnaires were analysed using content analysis to draw upon themes.FindingsDespite environmental/systemic challenges, the process of collecting narratives has highlighted the importance of a good therapeutic relationship between staff and clients. Conclusion: It is important to note that it is not the number of narratives collected which is important but the quality of the narratives and what both staff member and client gain from the process which is key.
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Tardaskina, T. M., I. V. Stankevych i H. O. Sakun. "Management of a Commercial Bank on the Basis of Client Orientation". Business Inform 1, nr 528 (2022): 373–82. http://dx.doi.org/10.32983/2222-4459-2022-1-373-382.
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The purpose of the article is to develop theoretical and methodological aspects of managing a modern commercial bank using a client-oriented approach. As a result of the study, the most reliable commercial banks were evaluated according to the National Bank of Ukraine, namely: JSC «Raiffeisen Bank», JSC «UkrSibbank» and JSC «Credit Agricole Bank», among which JSC «Credit Agricole Bank» was identified as the most client-oriented commercial bank. It is a veritably reliable bank with foreign capital that steadily increases its client base and its market share, paying special attention to the categories of clients such as middle-class and agricultural area, effectively managing risk and profit. The authors came to the conclusion that the introduction of a client-oriented strategy ensures sales growth, lower costs for attracting new clients, increasing cross-sales, strengthening market positions, profit growth. The work identifies and substantiates practical recommendations for the formation of a modern client-oriented attractive commercial bank. The study considers such components as: organization structure, format of branches, corporate culture, qualification of staff, its attitude to the client, information and computer support, communication with the client, image, reputation of the bank, quality of services. It is proposed to segment the client base into separate groups of clients, which are the directions of further research by the authors of the article. This approach will allow to assess the possibilities of mutually beneficial cooperation with different groups of clients, define the profile of clients to determine the optimal way to promote a banking product/services, differentiate the price of banking products/services for various clients.
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Critten, Danielle R., Jill L. Bezyak i Juliet H. Fried. "The Importance of Positive Client-Staff Social Interactions in Inpatient Psychiatric Rehabilitation Programs". Journal of Applied Rehabilitation Counseling 44, nr 2 (1.06.2013): 29–34. http://dx.doi.org/10.1891/0047-2220.44.2.29.
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Social support has received much attention and empirical support as being a key component of the psychiatric rehabilitation of individuals with serious mental illness (SMI). Social dysfunction is often a defining characteristic of SMI, and interventions targeting social deficits help to improve client outcomes. The provision of social skills training and psychoeducation to improve social interactions and client knowledge of their illness and treatment options is vital in psychiatric rehabilitation. Since most patient interactions in an inpatient facility are with staff members and others with SMI, staff members must be mindful of the nature of individuals' illnesses, as well as their style of communication with the clients they serve as these are closely associated with rehabilitation outcomes. Staff members also are in charge of educating individuals about their illness and treatment options, and they should be knowledgeable about the information they are imparting. Recommendations for approaches to better prepare inpatient staff members to work with persons with SMI are provided.
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oliveras, elizabeth, ulla larsen i patricia h. david. "client satisfaction with abortion care in three russian cities". Journal of Biosocial Science 37, nr 5 (16.08.2005): 585–601. http://dx.doi.org/10.1017/s0021932004006960.
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this paper explores client satisfaction with abortion care, looking at overall satisfaction and satisfaction with hygiene, comfort and courtesy. the analysis aimed to determine whether client satisfaction was related to the characteristics of the client, in order to guide quality improvement efforts. the analysis is a secondary analysis of data collected in a survey of 489 abortion clients who attended a limited number of hospitals in three cities in russia. the data were analysed using logistic regression. client characteristics, in general, did not affect overall satisfaction though there were significant differences in overall satisfaction for unmarried versus married women (or=0·29, ci=0·13, 0·63). similarly, most characteristics of the abortion visit were not related to client satisfaction, although women who were awake for the procedure were less likely to be satisfied (or=0·37, ci=0·16, 0·89). information provided to abortion clients about self-care was the most important predictor of overall satisfaction for abortion clients (or=3·55, ci=1·64, 7·69). this suggests that improving the information provided to clients, through training providers and other staff, is important in these settings.
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Hatfield, Richard Charles. "The Effect of Staff Accountant Objectivity in the Review and Decision Process: A Tax Setting". Journal of the American Taxation Association 23, nr 1 (1.03.2001): 61–74. http://dx.doi.org/10.2308/jata.2001.23.1.61.
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Prior studies report that less experienced staff accountants are often susceptible to confirmation bias in the evaluation of evidence. This bias results in nonobjective information evaluation by staff-level accountants. This study examines how the perceived objectivity of the staff accountant and the manager's own client advocacy affect the manager's use of the staff accountant's research report when formulating client recommendations. The results suggest that objectivity judgments made by partner-/manager-level accountants are influenced by whether the staff accountant's research report confirms their initial opinion. Further, the confirmatory nature of the research report affects the manner in which the report is incorporated into a client recommendation. Nonconfirming research reports were given more weight than confirming research reports. Preference for client-favorable outcomes was found to affect the weight given to staff accountant research reports as well.
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Klein, Edward B., Walter N. Stone, Mitchell W. Hicks i Ian L. Pritchard. "Understanding Dropouts". Journal of Mental Health Counseling 25, nr 2 (1.04.2003): 89–100. http://dx.doi.org/10.17744/mehc.25.2.xhyreggxdcd0q4ny.
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This study examined differences between clients who did or did not notify mental health providers of intent to discontinue treatment. Clients who did not notify were more likely to be women, attend less than four sessions, and rate their overall functioning lower. Both groups showed significant improvement, and self-reports were found to be a better indicator of progress than counselor estimates. Findings suggested that the adoption of mutual goals and empathetic counselor attitudes toward client treatment expectations might increase staff awareness of satisfied dropouts who have made therapeutic gains. Implications include benefits to staff morale and the larger Community Mental Health Center system in which almost half of all clients discontinue treatment without informing staff.
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Novotná, Gabriela, Karen A. Urbanoski i Brian R. Rush. "Client-Centered Design of Residential Addiction and Mental Health Care Facilities". Qualitative Health Research 21, nr 11 (1.07.2011): 1527–38. http://dx.doi.org/10.1177/1049732311413782.
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In this article we discuss the findings from a series of focus groups conducted as part of a 3-year, mixed-method evaluation of clinical programs in a large mental health and substance use treatment facility in Canada. We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored.
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Meador, Rhoda, Emily Chen, Leslie Schultz, Amanda Norton, Charles Henderson, i Karl Pillemer. "Going Home: Identifying and Overcoming Barriers to Nursing Home Discharge". Care Management Journals 12, nr 1 (marzec 2011): 2–11. http://dx.doi.org/10.1891/1521-0987.12.1.2.
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This article describes barriers to nursing home discharge encountered in an intervention designed to transition nursing home residents to the community. Staff in the intervention (“Project Home”) provided intensive case management and discharge planning services to nursing home residents who expressed a desire to return to community-based living arrangements. Sixty program participants took part in the program evaluation that informs this article. With the exception of Medicaid status, no differences were found between the social, demographic, and health characteristics of individuals who remained in the nursing home and those who were discharged. A qualitative analysis was conducted to describe barriers to discharge and strategies intervention staff used to leverage each client’s strengths and work around obstacles. Three main barriers to discharge were found: having an unstable or complex medical condition, lacking family or social support, and being unable to obtain suitable housing. Intervention staff advocated on the behalf of clients, encouraged clients to build skills toward independent living, and contributed extensive knowledge of local resources to advance client goals. Cases of successful transition suggest that a person-centered approach from intervention staff combined with a flexible organizational structure is a promising model for future interventions.
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Harvey, C., H. Killaspy, S. Martino, S. White, S. Priebe, C. Wright i S. Johnson. "A comparison of the implementation of Assertive Community Treatment in Melbourne, Australia and London, England". Epidemiology and Psychiatric Sciences 20, nr 2 (18.03.2011): 151–61. http://dx.doi.org/10.1017/s2045796011000230.
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Aims.The efficacy of Assertive Community Treatment (ACT) is well established in the USA, and to a lesser extent in Australia, whereas UK studies suggest little advantage for ACT over usual care. Implementation of ACT varies and these differences may explain variability in reported efficacy. We aimed to investigate differences in ACT implementation between Melbourne, Australia and London, UK.Methods.In a cross-sectional survey, we investigated team organisation, staff and client characteristics from four Melbourne ACT teams using almost identical methods to the Pan London Assertive Outreach studies of 24 ACT teams.Results.Client characteristics, staff satisfaction and burnout were very similar. Three of four Melbourne teams made over 70% of client contacts ‘in vivo’ compared to only one-third of comparable London teams, although all teams were rated as ‘ACT-like’. Melbourne teams scored more highly on team approach. Three quarters of clients were admitted in the preceding 2 years but Melbourne clients had shorter stays.Conclusions.Differences in the implementation of ‘active components’ of home treatment models that have been associated with better client outcomes (home visiting, team approach) may explain international differences in ACT efficacy. Existing fidelity measures may not adequately weight these important elements of the model.
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Hinde, Jesse M., Bryan R. Garner, Colleen J. Watson, Rasika Ramanan, Elizabeth L. Ball i Stephen J. Tueller. "The implementation & sustainment facilitation (ISF) strategy: Cost and cost-effectiveness results from a 39-site cluster randomized trial integrating substance use services in community-based HIV service organizations". Implementation Research and Practice 3 (styczeń 2022): 263348952210892. http://dx.doi.org/10.1177/26334895221089266.
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Background: As part of the Substance Abuse Treatment to HIV Care Project, the Implementation & Sustainment Facilitation (ISF) strategy was found to be an effective adjunct to the Addiction Technology Transfer Center (ATTC) strategy for integrating a motivational interviewing-based brief intervention (MIBI) for substance use disorders. This study presents the cost and cost-effectiveness results. Methods: Thirty-nine HIV service organizations were randomized to receive the ATTC-only condition or the ATTC + ISF condition. Two staff from each organization received the ATTC-training. In ATTC + ISF organizations, the same two staff and additional support staff participated in facilitation sessions to support MIBI implementation. We estimated costs using primary data on the time spent in each strategy and the time spent delivering 409 MIBIs to clients. We estimated staff-level cost-effectiveness for the number of MIBIs delivered, average MIBI quality scores, and total client days abstinent per staff. We used sensitivity analyses to test how changes to key variables affect the results. Results: Adjusted per-staff costs were $2,915 for the ATTC strategy and $5,371 for ATTC + ISF, resulting in an incremental cost of $2,457. ATTC + ISF significantly increased the number of MIBIs delivered (3.73) and the average MIBI quality score (61.45), yielding incremental cost effectiveness ratios (ICERs) of $659 and $40. Client days abstinent increased by 59 days per staff with a quality-adjusted life-year ICER of $40,578 (95% confidence interval $29,795–$61,031). Conclusions: From the perspective of federal policymakers, ISF as an adjunct to the ATTC strategy may be cost-effective for improving the integration of MIBIs within HIV service organizations, especially if scaled up to reach more clients. Travel accounted for nearly half of costs, and virtual implementation may further increase value. We also highlight two considerations for cost-effectiveness analysis with hybrid trials: study protocols kept recruitment low and modeling choices affect how we interpret the effects on client-level outcomes.
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Nord, Catharina. "Confidentiality in Architectural Space: A Study of HIV Healthcare Facilities in Uganda". Open House International 33, nr 4 (1.12.2008): 53–62. http://dx.doi.org/10.1108/ohi-04-2008-b0007.
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This article analyses and discusses spatial conditions contributing to confidentiality in HIV healthcare facilities carried out by two non-governmental organisations in Uganda, the AIDS Information Centre (AIC) and The AIDS Support Organisation (TASO). The provision of confidential space was found to be the most important architectural quality promoting client wellbeing, where Voluntary Counselling and Testing (VCT) as well as ongoing services to people living with HIV are provided. The study shows that confidential space is a requirement in a number of situations: when the client approaches the health centre; during the visit; and in the meeting between client, counsellor and medical staff. An unobtrusive location of the centre and separate, private counselling rooms are thus the most favourable spatial conditions. This article is based on a qualitative, explorative case study carried out in Jinja, Uganda during four months in 2004. Direct observation, interviews, primarily with clients and staff, spatial analyses and a qualitative content analysis were carried out.
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Clarke, Jenelle Marie. "The case for “fluid” hierarchies in therapeutic communities". Therapeutic Communities: The International Journal of Therapeutic Communities 38, nr 4 (11.12.2017): 207–16. http://dx.doi.org/10.1108/tc-05-2017-0016.
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Purpose Democratic therapeutic communities (TCs), use a “flattened hierarchy” model whereby staff and clients are considered to have an equal voice, sharing administrative and some therapeutic responsibility. Using the sociological framework of interaction ritual chain theory, the purpose of this paper is to explain how TC client members negotiated and enforced community expectations through an analysis of power within everyday interactions outside of structured therapy. Design/methodology/approach The study used narrative ethnography, consisting of participant observation with two democratic communities, narrative interviews with 21 client members, and semi-structured interviews with seven staff members. Findings The findings indicate social interactions could empower clients to recognise their personal agency and to support one another. However, these dynamics could be destructive when members were excluded or marginalised. Some clients used their interactions at times to consolidate power amongst dominant members. Practical implications It is argued that the flattened hierarchy approach theoretically guiding TC principles does not operate as a flattened model in practice. Rather, a fluid hierarchy, whereby clients shift and change social positions, seems more suited to explaining how the power structure worked within the communities, including amongst the client group. Recognising the hierarchy as “fluid” may open dialogues within TCs as to whether, and how, members experience exclusion. Originality/value Explorations of power have not specifically focused on power dynamics between clients. Moreover, this is one of the first papers to look at power dynamics outside of structured therapy.
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Catbagan, Angela Mae C., Enrico L. Torres i Mary Caroline N. Castaño. "THE IMPACT OF CLIENT CENTRICITY STRATEGY ON THE RETENTION OF CLIENTS IN SELECTED COMMERCIAL BANKS IN MAKATI AREA". Advanced International Journal of Banking, Accounting and Finance 4, nr 13 (31.12.2022): 17–32. http://dx.doi.org/10.35631/aijbaf.413002.
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Client-centricity strategy is an approach that theorizes that serving clients’ needs leads to their retention. In the advent of the current pandemic, banks must also leverage their approach to the current situation to retain clients. This study aims to provide information to financial institutions, particularly the banking sector that nowadays is going through a diverse change in strategic approach. The study investigated the impact of client-centricity strategy on the retention of clients in selected commercial banks in Makati area through the perception of bank employees. Using the quantitative approach and descriptive design, this study determined the impact of client-centricity through its four pillars (targeting, metric, value proposition, and cross-departmental collaboration) on retention. Analysis was done on employees of five commercial banks (based on the April 2022 BSP Directory of Universal and Commercial Banks) through stratified random sampling to determine client-centric usage. A total of 153 officers answered the strategy questionnaire and 163 staff answered for the level of retention. By Pearson correlation, multi-comparison, and Bootstrap corrected and accelerated (Bca) regression analyses, the pillars of client-centricity strategy influence on client retention were statistically significant at 5% level; with metrics as the highest impact among others when utilized as bank indicators for client retention. The five commercial banks in Makati believed and agreed that the utility of these strategies leads to more clients retained. Satisfied clients are retained because they are carefully targeted, have successful relationships with the bank (metric), interact with customers (value proposition), and trust that cross-departmental collaboration flow within the firm.
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Hare, Dougal Julian, Marianne Durand, Steve Hendy i Anja Wittkowski. "Thinking About Challenging Behavior: A Repertory Grid Study of Inpatient Staff Beliefs". Intellectual and Developmental Disabilities 50, nr 6 (1.12.2012): 468–78. http://dx.doi.org/10.1352/1934-9556-50.06.468.
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Abstract Studies examining staff attitudes toward people with intellectual disability have traditionally used pre-determined categories and models or been open to researcher bias. The use of methods derived from personal construct psychology permits an objective investigation of staff views and attitudes without such limitations. Fourteen staff from an inpatient intellectual disability service were interviewed about their perceptions of clients with challenging behavior primarily using the repertory grid technique as developed from personal construct theory. Staff was found to construe their clients and their behaviors in a heterogeneous manner that was not readily reducible to a group average, and they did not make or use attributions about them in a consistent manner. Future research should incorporate work culture and the staff–client relationship. The results have implications for clinical decision making, team working, and clinical supervision.
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Barrick, John A., C. Bryan Cloyd i Brian C. Spilker. "The Influence of Biased Tax Research Memoranda on Supervisors' Initial Judgments in the Review Process". Journal of the American Taxation Association 26, nr 1 (1.03.2004): 1–19. http://dx.doi.org/10.2308/jata.2004.26.1.1.
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This study experimentally investigates the effects of confirmation bias underlying staff-level tax research on supervisors' initial assessments and recommendations made during the review process for tax research memoranda. The theoretical framework underlying our hypotheses posits that tax professionals strive to make recommendations that meet both accuracy and advocacy objectives. Participants in our study addressed a client scenario in which both objectives could not be met because the client-preferred position did not have a “realistic possibility” of being successfully defended on its merits. In this context, we find that supervisors are more persuaded by an unbiased memo correctly concluding that the client-preferred position is not appropriate than by a biased memo reaching the same conclusion. This result suggests that when tax research memoranda are not consistent with the client advocacy objective, professionals are more persuaded by memoranda that fulfill their accuracy objective. On the other hand, we also find that supervisors are more persuaded by a biased memo incorrectly concluding in favor of the client's preferred position than by a biased memo correctly concluding that the client-preferred position is inappropriate. This result suggests that, when neither memorandum meets the accuracy objective, supervisors are more persuaded by memoranda that offer encouragement that their advocacy objective might be met than by those that do not. Finally, results also indicate that supervisors act to correct confirmation bias by requesting more rework of staff who prepare biased memos than of staff who prepare unbiased memos.
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Jolley, Gwyneth, Libby Kalucy i Joanne McNamara. "Obtaining and Using Client Feedback in Community Health Services". Australian Journal of Primary Health 4, nr 4 (1998): 105. http://dx.doi.org/10.1071/py98066.
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Client feedback is an important component of two primary health care strategies: participation and evaluation. Workers need feedback from clients to ensure that their practice meets the criterion of providing affordable, accessible and appropriate services to enhance the health of their communities. Telephone interviews were conducted with thirty staff and thirty clients from women's and community health services in South Australia, to identify current practice in obtaining and using feedback from users of one-to-one services and group health promotion and community development activities. Factors which encourage feedback to be given and used include: trust and effective communications between all stakeholders; and supportive organisational philosophies, culture and practices. Client feedback is more likely to be used when given in written form. Collection and use of feedback are discouraged by inappropriate methods and timing, rapid organisational change, and clients' lack of awareness of, or confidence in, giving feedback about the services they receive. Verbal feedback, although preferred by many clients, is less likely to be recorded and used in service planning and evaluation. Client feedback is a valuable tool to reinforce the notion of partnership and power sharing between clients and health care workers. Staff at all levels should be engaged in obtaining feedback and the information gained should be disseminated throughout the agency in order to improve the quality and effectiveness of services. The challenge is now for service providers and users to adopt new, and support currently successful, ways of obtaining and using feedback so that service providers and users are engaged in working in partnership to ensure the needs of the community are best met.
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Bennett, G. Bradley, i Richard C. Hatfield. "The Effect of the Social Mismatch between Staff Auditors and Client Management on the Collection of Audit Evidence". Accounting Review 88, nr 1 (1.08.2012): 31–50. http://dx.doi.org/10.2308/accr-50286.
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ABSTRACT: This study provides both survey and experimental evidence to consider how social interactions between staff-level auditors and client management may affect staff auditors' perceptions and influence their decisions regarding the collection of audit evidence. During fieldwork, staff-level auditors have extensive interaction with client management. Survey evidence suggests that these staff-level auditors are often “mismatched” with client management, in terms of their experience, age, and accounting knowledge. Experimental results indicate that staff-level auditors may reduce the extent to which they collect evidence to avoid these interactions. Finally, the use of email communication with client management helped to mitigate the reduction in evidence collected caused by avoiding in-person interactions. Interestingly, when not collecting all the evidence, approximately half of the participants documented their findings in a vague or inappropriate manner, which would likely reduce the likelihood that reviewing auditors would identify a problem. Given the extent of audit evidence collected by young staff auditors, these findings have direct implications for workpaper and audit quality. Data Availability: Data and materials used in this study are available upon request.
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Schulz, Rockwell, James R. Greenley i Roger Brown. "Organization, Management, and Client Effects on Staff Burnout". Journal of Health and Social Behavior 36, nr 4 (grudzień 1995): 333. http://dx.doi.org/10.2307/2137323.
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Sullivan, Cornelius W., i Irving S. Yudelowitz. "Goals of Hospital Treatment: Staff and Client Perceptions". Perspectives in Psychiatric Care 32, nr 1 (16.01.2009): 4–6. http://dx.doi.org/10.1111/j.1744-6163.1996.tb00491.x.
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Casswell, Geraldine, i Jennifer English. "Copying letters to patients three years on: An audit project to evaluate changes in a child and adolescent mental health service". Clinical Psychology Forum 1, nr 203 (listopad 2009): 34–38. http://dx.doi.org/10.53841/bpscpf.2009.1.203.34.
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An audit repeated after three years to look at the staff practice in CAMHS of copying letters to clients showed a substantial change in favour of copying letters. For a third of clinicians the letter is now addressed to the client and copied to the referrer.
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Meehan, Ashley A., Michael Yeh, Annette Gardner, Tiera L. DeFoe, Alberto Garcia, Patrick Vander Kelen, Martha P. Montgomery i in. "COVID-19 Vaccine Acceptability Among Clients and Staff of Homeless Shelters in Detroit, Michigan, February 2021". Health Promotion Practice 23, nr 1 (23.10.2021): 35–41. http://dx.doi.org/10.1177/15248399211049202.
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Understanding COVID-19 vaccine acceptability among clients and staff of homeless shelters can inform public health efforts focused on communicating with and educating this population about COVID-19 vaccines and thus improve vaccine uptake. The objective of this study was to assess COVID-19 vaccine acceptability and uptake among people in homeless shelters in Detroit, Michigan. A cross-sectional study was conducted from February 9 to 23, 2021. Seventeen homeless shelters were surveyed: seven male-only, three male/female, and seven women and family shelters. All clients and staff aged ≥18 years and able to complete a verbal survey in English or with a translator were eligible to participate; of the 168 individuals approached, 26 declined, leaving a total sample of 106 clients and 36 staff participating in the study. The median client and staff ages were 44 and 54 years, respectively. Most participants (>80%) identified as non-Hispanic Black or African American. Sixty-one (57.5%) clients and 27 (75.5%) staff had already received or planned to receive a COVID-19 vaccination. Twelve (11.3%) clients and four (11.1%) staff were unsure, and 33 (31.1%) clients and five (13.9%) staff did not plan to get vaccinated. Reasons for hesitancy were concerns over side effects (29 clients [64.4%] and seven staff [77.8%]) and unknown long-term health impacts (26 clients [57.8%] and six staff [66.7%]). More than half of the clients had already received or planned to receive the vaccine. Continuing efforts such as vaccine education for hesitant clients and staff and having accessible vaccine events for this population may improve acceptability and uptake.
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Cardona, Carolina, Funmilola M. OlaOlorun, Elizabeth Omulabi, Peter Gichangi, Mary Thiogo, Amy Tsui i Philip Anglewicz. "The relationship between client dissatisfaction and contraceptive discontinuation among urban family planning clients in three sub-Saharan African countries". PLOS ONE 17, nr 8 (22.08.2022): e0271911. http://dx.doi.org/10.1371/journal.pone.0271911.
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Although researchers and practitioners have suggested that the quality of family planning services impacts contraceptive discontinuation, establishing a causal relationship has been challenging, primarily due to data limitations and a lack of agreement on how to measure quality. This longitudinal study estimated the relationship of the dissatisfaction with family planning services on contraceptive discontinuation for a sample of 797 female clients who sought family planning services at urban facilities across Kenya, Nigeria, and Burkina Faso. Clients who sought family planning services were first interviewed in person at private and public health facilities and received a follow-up phone interview four to six months later. In our sample, 18.2% of clients who were using a modern contraceptive at baseline stopped using it by follow-up. At baseline, nearly 14% of clients reported experiencing a problem with service convenience, nearly 12% with the availability of medicines and contraceptives, and nearly 6% with facility cleanliness and/or staff treatment. We hypothesized that client dissatisfaction with the family planning services received informed their decision to discontinue contraception and estimated univariate and bivariate probit regression models, controlling for individual and health facility characteristics. We found that client’s perceptions of staff treatment and facility cleanliness informed their expectations about service and contraceptive standards, affecting subsequent contraceptive discontinuation. The difference in the probability of discontinuing contraception was 8.2 percentage-points between dissatisfied and satisfied clients. Examining client dissatisfaction with family planning services can inform the family planning community on needed improvements to increase contraceptive adherence for women in need, which can prevent unplanned pregnancies and unwanted births in the long run.
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Liou, Chih-ling. "PROFESSIONAL CAREGIVERS’ PERCEPTIONS OF PEOPLE WITH DEMENTIA AT ADULT DAY SERVICES IN TAIWAN: THE EFFECTS ON CLIENTS". Innovation in Aging 3, Supplement_1 (listopad 2019): S376. http://dx.doi.org/10.1093/geroni/igz038.1377.
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Abstract This study aims to explore staff perception of their clients with dementia in five ADS centers in Taiwan. Focused ethnography was used to collect data from 45 individual interviews with nurse’s aides, nurses, social workers, housekeepers, volunteers, bus drivers and centers’ directors and 600 hours of field observations. The findings from the content analysis revealed two themes reflecting ADS staff’s attitudes towards clients: (1) labeling the clients as “old” or “sick” to distance themselves from the clients and (2) viewing the clients as their aging relatives and over-helping them. Both attitudes not only affected staff-client relationships but also influenced how clients viewed themselves by inducing self-labeling of incompetent and dependent. More dementia-specific and communication training is needed for staff at ADS centers in Taiwan to change their attitudes and behavior toward clients with dementia. With a more positive attitude of people with dementia, the prerequisites for person-centered care will improve.
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O’Grady, Megan A., Rina Randrianarivony, Keith Martin, Yaberci Perez-Cubillan, David C. Collymore, Dina Shapiro-Luft, Alexa Beacham, Nyasia Heyward, Belinda Greenfield i Charles J. Neighbors. "Together in care: Lessons learned at the intersection of integrated care, quality improvement, and implementation practice in opioid treatment programs". Implementation Research and Practice 3 (styczeń 2022): 263348952211352. http://dx.doi.org/10.1177/26334895221135265.
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Background Integrated care programs that systematically and comprehensively address both behavioral and physical health may improve patient outcomes. However, there are few examples of such programs in addiction treatment settings. This article is a practical implementation report describing the implementation of an integrated care program into two opioid treatment programs (OTPs). Method Strategies used to implement integrated care into two OTPs included external facilitation, quality improvement (QI) processes, staff training, and an integrated organizational structure. Service, implementation, and client outcomes were examined using qualitative interviews with program staff (n = 16), program enrollment data, and client outcome data (n = 593) on mental health (MH), physical health, and functional indicators. Results Staff found the program to generally be acceptable and appropriate, but also noted that the new services added to already busy workflows and more staffing were needed to fully reach the program's potential. The program had a high level of penetration (∼60%–70%), enrolling over 1,200 clients. Staff noted difficulties in connecting clients with some services. Client general functioning and MH symptoms improved, and heavy smoking decreased. The organizational structure and QI activities provided a strong foundation for interactive problem-solving and adaptations that were needed during implementation. Conclusions This article highlights an example of the intersection of QI and implementation practice. Simplified QI processes, consistent post-implementation meetings, and change teams and champions facilitated implementation; however, ongoing training and support, especially related to data are needed. The OTP setting provided a strong foundation to build integrated care, but careful consideration of new workflows and changes in philosophy for staff is necessary. Plain Language Summary: Providing medical and behavioral health treatment services in the same clinic using coordinated treatment teams, also known as integrated care, improves outcomes among those with chronic physical and behavioral health conditions. However, there are few practical examples of implementation of such programs in addiction treatment settings, which are promising, yet underutilized settings for integrated care programs. A multi-sectoral team used quality improvement (QI) and implementation strategies to implement integrated care into two opioid treatment programs (OTPs). The program enrolled over 1,200 clients and client general functioning and mental health (MH) symptoms improved, and heavy smoking decreased. Qualitative interviews provided important information about the barriers, facilitators, and context around implementation of this program. The OTP setting provided a strong foundation to build integrated care, but careful consideration of new workflows and changes in philosophy for staff, as well as ongoing training and supports for staff, are necessary. This project may help to advance the implementation of integrated care in OTPs by identifying barriers and facilitators to implementation, lessons learned, as well as providing a practical example of potentially useful QI and implementation strategies.
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Coetzee, Johan. "Client-Centricity In South African Retail Banking". International Business & Economics Research Journal (IBER) 13, nr 5 (23.08.2014): 997. http://dx.doi.org/10.19030/iber.v13i5.8767.
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Client-centricity deals with addressing the needs of clients as they change. It requires contact-personnel who are empowered to not only identify client needs, but address them speedily. This study investigated the perceptions of client-centricity for 559 contact-personnel at three major South African retail banks in central South Africa. The results indicate that in general the contact personnel regard their respective banks as enforcing a client-centric strategy. They do however feel that the support from administrative personnel and the processes that support the sales environment are not always conducive to client-centric principles. This is a particular problem as contact-personnel are attuned to addressing the sales-related product and service offerings of clients as opposed to the process-related administrative burdens attached to the delivery of such products and services. The study also found that the job function of contact-personnel is the most important factor to consider when developing a client-centric strategy. Further to this, contact-personnel with the longest number of years of experience in a specific function are the best to use for management when determining whether or not specific tools to achieve client-centricity are effective. The major contribution of the study is that it focuses specifically on the perceptions of contact-personnel and thus provides additional knowledge of what the bank (through its client-facing staff) itself considers important with regards to client-centricity.
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Baldry, Eileen, Sue Green i Katrina Thorpe. "Urban Australian Aboriginal peoples’ experience of human services". International Social Work 49, nr 3 (maj 2006): 364–75. http://dx.doi.org/10.1177/0020872806063410.
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English Urban Aboriginal communities were asked about their experiences of human services. The misuse of Aboriginal liaison staff, the attitudes of staff and policy-makers, the invisibility of Aboriginal clients, poor communication, lack of access to services, client rights and lack of integration were raised. Respect for Aboriginal persons’ social citizenship is discussed. French Il a été demandé aux communautés aborigènes urbaines de décrire leur expérience des services humains disponibles. Les dilemmes suivants ont été soulevés: une mauvaise utilisation des employés assurant la liaison, certaines attitudes d'employés et de développeurs de politiques, un manque de visibilité de la clientèle aborigène, des communications déficientes, des difficultés d'accès aux services, les droits des clients et un manque d'intégration. Une discussion sur le respect pour la citoyenneté sociale des personnes aborigènes est présentée dans l'article. Spanish Se pidió información a las comunidades aborígenes urbanas sobre sus experiencias como usuarios de los servicios humanos. Se trataron los siguientes temas: el mal uso de los empleados aborígenes en su función conectora, las actitudes de los empleados y políticos, la invisibilidad del cliente aborigen, la mala comunicación, la falta de acceso a los servicios, la falta de integración, y cuestiones de derechos del cliente. Se explora la cuestión de la ciudadanía social de los aborígenes.
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Davis, Dana, Mary Hawk i Dana Winkler. "Because the clients told us so". Housing, Care and Support 20, nr 4 (18.12.2017): 164–74. http://dx.doi.org/10.1108/hcs-08-2017-0021.
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Purpose Eliciting client narratives and creating community-informed interventions have been effective methods of engaging those who are unstably housed in care. Previous studies have shown that these approaches foster client empowerment and provide insight as to the importance of creating community-driven solutions. However, few studies report the impact of these methods on homeless people living with HIV. The purpose of this paper is to describe methods used to engage consumers in sharing their stories, including formative focus groups, qualitative interviews, and feedback from peer staff. Design/methodology/approach Data for the case study were derived from program notes, board minutes, and feedback from founding board members of The Open Door. Two researchers who were involved with the program from its inception reviewed these data and then developed a schematic of the methods used to develop and inform the program itself. The authors determined that three methods were used to elicit client and community narratives to inform program decisions. These include a formative focus group that helped to structure and implement the program in its earliest stages; qualitative interviews, which helped to pinpoint effective program components and enabled the rapid expansion of the service delivery model; and feedback from peer staff, which has consistently allowed for the refinement and prioritization of services. Data were collected for the purposes of program development and improvement but since qualitative interviews were conducted by faculty affiliated with an academic institution, the institutional review board of that institution was consulted and the qualitative interviews were determined to be exempt from review. Findings The focus group informed the authors that they wanted to live in their own apartments but have on-site supports. They also indicated that traditional housing program rules such as abstinence were too restrictive for them to navigate. In the qualitative interviews, the clients reported an increased sense of community with peers and peer staff members, which helped to reduce stigma. Second, residents reported that supportive services helped them to connect to and maintain in HIV clinical care. Third, residents reported that the representative payee services were a key factor in helping them improve housing and financial stability. Research limitations/implications There are a number of limitations to this case study that demand the need for caution in interpreting results. Although the authors used several different methods to elicit client narratives and community feedback, sample sizes were small, control groups were not utilized, and data were specific to individuals receiving services through one housing program. Thus, results are not generalizable. In addition, the methods reported herein mix those conducted for the purposes of research (in-depth qualitative interviews) with others conducted specifically to inform program delivery and improvement (focus group and peer staff feedback). Thus, rigor is not equally applied across all methods. In addition, the individuals conducting research and authoring this paper were directly involved with the creation of the program and ongoing service delivery. Therefore, interviewer and reporting bias also present threats to validity. Practical implications There are many strengths involved in utilizing the narrative feedback of the residents and peer staff to inform the practice. One is that this method is an incredibly cost-efficient way to assess client and program needs to inform intervention development and improvement. The results are also very transparent and easily translatable to the agency’s everyday work. These methods are practical in both their approach to clients and their ability to be easily incorporated into the daily work of clients and staff. These methods allow for rapid application as results are immediate and feedback can be implemented quickly. Social implications When seeking client and staff feedback, it is important to be cognizant of believing the client and recognizing that all people have their own personal perspectives, including their own version of the “truth.” Eliciting this type of feedback puts individuals in a vulnerable place, so it is critical to guarantee their safety. All information solicited must be regarded in a positive light to inform improved service delivery and not as a means to receive information that “tells on” clients or peer staff. Feedback should be reviewed as an opportunity for learning and not as a mechanism for retaliation. Originality/value The clients and staff have been significantly marginalized in the society. It is possible that having providers be kind and respectful to them and asking for their opinions is a very new experience which might make them feel grateful and more likely to be favorable in their responses. Clients may feel loyal to the program and be much more likely to speak of it positively. Regardless of these potential biases, the quantitative results of improved health outcomes published elsewhere indicate that the clients may not just be being nice, but may in fact be receiving interventions that are working.
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Barton, Elsa, Toby Freeman, Fran Baum, Sara Javanparast i Angela Lawless. "The feasibility and potential use of case-tracked client journeys in primary healthcare: a pilot study". BMJ Open 9, nr 5 (maj 2019): e024419. http://dx.doi.org/10.1136/bmjopen-2018-024419.
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ObjectivesTo determine the feasibility of case-tracking methods in documenting client journeys at primary healthcare (PHC) services in order to investigate the comprehensiveness of service responses and the experiences of clients.DesignProspective pilot study. Quantitative and qualitative case management data were collected from staff via questionnaire or interview.SettingFive Australian multidisciplinary PHC services were involved including four South Australian state-managed and one Northern Territory Aboriginal community-controlled PHC service.ParticipantsClients using services for depression (95) or diabetes (185) at the PHC services were case tracked over a 12-month period to allow construction of client journeys for these two conditions. Clients being tracked were invited to participate in two semi-structured interviews (21) and complete a health log.ResultsThough a number of challenges were encountered, the case-tracking methods were useful in documenting the complex nature of client journeys for those with depression or diabetes accessing PHC services and the need to respond to the social determinants of health. A flexible research design was crucial to respond to the needs of staff and changing organisational environments.ConclusionsThe client journeys provided important information about the services’ responses to depression and diabetes, and about aspects unique to comprehensive PHC such as advocacy and work that takes into account the social determinants of health.