3,306 research outputs found
The contribution of implementation science to improving the design and evaluation of integrated care programmes for older people with frailty
Full text linkPurposeThe purpose of this paper is to discuss three potential contributions from implementation science that can help clinicians and researchers to design and evaluate more effective integrated care programmes for older people with frailty.Design/methodology/approachThis viewpoint paper focuses on three contributions: stakeholder engagement, using implementation science frameworks, and assessment of implementation strategies and outcomes.FindingsStakeholder engagement enhances the acceptability of interventions to recipients and providers and improves reach and sustainability. Implementation science frameworks assess provider, recipient and wider context factors enabling and hindering implementation, and guide selection and tailoring of appropriate implementation strategies. The assessment of implementation strategies and outcomes enables the evaluation of the effectiveness and implementation of integrated care programmes for this population.Research limitations/implicationsImplementation science provides a systematic way to think about why integrated care programmes for older people with frailty are not implemented successfully. The field has an evidence base, including how to tailor implementation science strategies to the local setting, and assess implementation outcomes to provide clinicians and researchers with an understanding of how their programme is working. The authors draw out implications for policy, practice and future research.Originality/valueDifferent models to deliver integrated care to support older people with frailty exist, but it is not known which is most effective, for which individuals and in which clinical or psychosocial circumstances. Implementation science can play a valuable role in designing and evaluating more effective integrated care programmes for this population
Supplemental material for Collaborative patterns, authorship practices and scientific success in biomedical research: a network analysis
No full textSupplemental Material for Collaborative patterns, authorship practices and scientific success in biomedical research: a network analysis by Vanash M Patel, Pietro Panzarasa, Hutan Ashrafian, Tim S Evans, Ali Kirresh, Nick Sevdalis, Ara Darzi and Thanos Athanasiou in Journal of the Royal Society of Medicine</p
Perioperative medicine for Older People undergoing Surgery (POPS): A guide to designing, developing and embedding POPS services
No full textA prospective risk assessment of informal carers’ medication administration errors within the domiciliary setting
No full textIncreasingly, medication is being administered at home by family and friends of the care-recipient. This study aims to identify and analyse risks associated with potential drug administration errors made by informal carers at home. We mapped medication administration at home with a multidisciplinary team that included carers, healthcare professionals and patients. Evidence-based risk-analysis methodologies were applied: Healthcare Failure Modes and Effect Analysis (HFMEA), Systematic Human Error Reduction and Prediction Analysis (SHERPA) and Systems-Theoretic Accident Model and Processes (STAMP). The process of administration comprises seven sub-processes. Thirty-four possible failure modes were identified and six of these were rated as high risk. These highlighted that medications may be given with a wrong dose, stored incorrectly, not discontinued as instructed, not recorded, or not ordered on time, and often caused by communication and support problems. Combined risk analyses contributed unique information helpful to better understand the medication administration risks and causes within homecare
Implementing collaborative care for major depression in a cancer center: an observational study using mixed-methods
Full text linkObjectives: To describe the implementation of a collaborative care (CC) screening and treatment program for major depression in people with cancer, found to be effective in clinical trials, into routine outpatient care of a cancer center.
Method: A mixed-methods observational study guided by the RE-AIM implementation framework using quantitative and qualitative data collected over five years.
Results: Program set-up took three years and required more involvement of CC experts than anticipated. Barriers to implementation were uncertainty about whether oncology or psychiatry owned the program and the hospital's organizational complexity. Selecting and training CC team members was a major task. 90% (14,412/16,074) of patients participated in depression screening and 61% (136/224) of those offered treatment attended at least one session. Depression outcomes were similar to trial benchmarks (61%; 78/127 patients had a treatment response). After two years the program obtained long-term funding. Facilitators of implementation were strong trial evidence, effective integration into cancer care and ongoing clinical and managerial support.
Conclusion: A CC program for major depression, designed for the cancer setting, can be successfully implemented into routine care, but requires time, persistence and involvement of CC experts. Once operating it can be an effective and valued component of medical care
Slow culture: an introduction
No full text[Extract] There is a powerful message permeating our social lives today, found in our self-help networks, talkback television and radio shows, and online forums. It is a warning that, through technology and modernisation, our lifestyles have become increasingly hectic, fast, complex and immediate. 'Life', writes online author Leo Babauta (2009, para. 2), 'moves at such a fast pace that it seems to pass us by before we can really enjoy it'. We are encouraged to take a step back, to breathe deeply and 'slow down', in order to recapture the essence of 'real' living. By doing so, we can escape the seemingly endless stresses associated with our multi-tasked, time-compressed and instantaneous speed culture (Tomlinson 2007). This book presents illustrations of how people are beginning to disentangle themselves from a speed culture by embracing slowness. It is not simply a matter of slowing down, as the term implies, but of undertaking changes in the way we do things at an everyday level. Underpinning these transformations is a concern, as Babauta (2009) suggests, with the uniquely stressful lifestyles we are living in contemporary culture
Expanding healthcare failure mode and effect analysis: A composite proactive risk analysis approach
Full text linkHealthcare Failure Mode and Effect Analysis (HFMEA) is a systematic risk assessment method derived from high risk industries to prospectively examine complex healthcare processes. Like most methods, HFMEA has strengths and weaknesses. In this paper we provide a review of HFMEA's limitations and we introduce an expanded version of traditional HFMEA, with the addition of two safety management techniques: Systematic Human Error Reduction and Prediction Analysis (SHERPA) and Systems-Theoretic Accident Model and Processes – Systems-Theoretic Process Analysis (STAMP-STPA). The combination of the three methodologies addresses significant HFMEA limitations. To test the viability of the proposed hybrid technique, we applied it to assess the potential failures in the process of administration of medication in the home setting. Our findings suggest that it is both a viable and effective tool to supplement the analysis of failures and their causes. We also found that the hybrid technique was effective in identifying corrective actions to address human errors and detecting failures of the constraints necessary to maintain safety
Nick Earls launches 'Wisdom Tree' - a new model for novella publishing, 9 Jun 2016
No full textBrisbane author Nick Earls discusses 'Wisdom Tree' a new model for novella publishing with fellow author and UQ Senior Lecturer in writing Dr Kim Wilkins. In 2013, Nick Earls realised his five best story ideas would need padding to become novels and would lose something if he tried to trim them to short-story size. He had to write them, and they had to be novellas. He also realised it was time to confront head-on the publishing industry's reluctance to work with the novella form. The result is Wisdom Tree, a new model for novella publishing, a PhD project and a chance to turn his best ideas into a series of five novellas to be published as individual paper, e and audiobooks at monthly intervals from May to September 2016.Introductions by Professor Doune Macdonald, Acting Deputy Vice-Chancellor (Academic)
Nick de Grandmaison Jr. Reading Our Heritage by John Fisher
No full textAn audograph recording of Nick de Grandmaison Junior reading an excerpt from Our Heritage by John Fisher. The text details the author encountering Red Cloud and David Bearspaw, members of the Stoney tribe, in a Banff hotel lobby on their way to sit for Nicholas de Grandmaison. From here, the clip speaks to why he chose to paint Indigenous peoples, the history of the Blackfoot people, language and colonial contact.The University of Lethbridge Library received permission from the University of Lethbridge Archives and the Dr. Margaret (Marmie) Perkins Hess Gallery to digitize and display this content.Not yet availabl
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