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Article

Sally Dawn Boyden

The purpose of this paper is to explore what existing literature about the care home environment for people with dementia reveals. It also evaluates the implications for…

Abstract

Purpose

The purpose of this paper is to explore what existing literature about the care home environment for people with dementia reveals. It also evaluates the implications for practice, to show which parts of the care home environment staff feel have the most impact on the day to day lives of residents living with dementia. In turn, this paper seeks to feedback to care home management to improve practice and to contribute to research in care homes in the future.

Design/methodology/approach

A literature review forms the basis of this research, in addition to four semi-structured interview conducted with care home staff of different roles; allowing them to share their experiences with little restriction. Participants were recruited through informal discussions with the researcher before the research took place, as part of her job role and using purposive sampling.

Findings

Data were analysed using computer software Nvivo and identified four main categories which all participants discussed: social interaction, staff involvement, staff restrictions, staff involvement and physical elements of the environment. This research has shown the importance of staff presence in the care home environment to facilitate social interaction among residents with dementia.

Research limitations/implications

The sample is very small due to staff not having the time to take part in the interview and this itself is a key finding. Interviews were able to capture feelings but not the overall experience of interaction between resident and staff, which observations would have achieved if there was more time to conduct the research.

Originality/value

A literature review and qualitative research signifying the importance of staff presence in the care home setting in order for the residents to socially engage in their environment. However, it has also show the lack of time that is face by staff and the impact this has on people living with dementia.

Details

Working with Older People, vol. 19 no. 2
Type: Research Article
ISSN: 1366-3666

Keywords

Abstract

Details

Designing Environments for People with Dementia
Type: Book
ISBN: 978-1-78769-974-8

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Article

Jingyu Yu, Guixia Ma and Xiaoyan Jiang

The ageing of rural Chinese populations is challenging health and social policy, driving growth in rural nursing homes. Living environment plays a role in enhancing…

Abstract

Purpose

The ageing of rural Chinese populations is challenging health and social policy, driving growth in rural nursing homes. Living environment plays a role in enhancing elderly quality of life (QoL), however, the impact of the built environment and care services are under-studied. The purpose of this paper is to investigate the influence of the built environment and care services on the QoL of elderly people within rural nursing homes in China.

Design/methodology/approach

A total of 242 residents of nursing home were surveyed, of which 76 percent were male and 24 percent were female. In total, 25.6 percent were aged between 60 and 69, 40.1 percent between 70 and 79, 31 percent between 80 and 89, and 3.3 percent were 90 or above. Quantitative data were analyzed through factor analysis, reliability test and multiple regression modeling.

Findings

The authors identified six built environment factors (room distance, space, barrier-free design, indoor environment, fire safety, and support facilities) and three services factors (i.e. daily care services, cleaning services, and healthcare services). QoL was measured over four dimensions: QoL, physical health, psychological health, and social relationships. Elderly QoL could be accurately predicted from room distance, space, barrier-free design, indoor environment, daily care services, and cleaning services.

Practical implications

Interventions in design of the built environment and the provision of care services are proposed, including dimensions of living space, heating, and provisions for qualified care providers.

Originality/value

This paper provides a clear picture about elderly special requirements on their built environment and healthcare services, helping architects, engineers and facilities managers understand elderly needs and improve built environment during design and operation stages.

Details

Engineering, Construction and Architectural Management, vol. 24 no. 6
Type: Research Article
ISSN: 0969-9988

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Article

Paula Lentz, Kristy Lauver and Jennifer Johs‐Artisensi

The purpose of this paper is to investigate how one hospital safety coordinator socially constructs a complete environment of care. Specifically, it applies Shotter's…

Abstract

Purpose

The purpose of this paper is to investigate how one hospital safety coordinator socially constructs a complete environment of care. Specifically, it applies Shotter's “practical author” framework to examine the author‐response interaction between the safety coordinator and other mid‐level supervisors.

Design/methodology/approach

Qualitative methodology is employed to examine this authorship. Data include printed materials employees receive upon hire, an observation of an environment of care orientation presentation, and semi‐structured interviews with the safety coordinator and mid‐level supervisors.

Findings

The paper reveals how the safety coordinator uses a variety of rhetorical strategies to balance the tensions between mandating compliance with environment of care requirements and facilitating buy‐in to the idea of compliance as a moral and ethical imperative. This creates an ethos among the employees where they feel authorized to go beyond the requirements and act on their own to construct a safer culture.

Research limitations/implications

The paper has multiple practical and theoretical implications that may be useful to health care and other organizations when examining the broader need for a complete, supportive environment where employees not only comply with but actually live and believe in the values of their organizations' cultures. A limitation is that employee perspective and behavior are primarily inferred based on supervisor reports.

Originality/value

The paper extends theory on communication and developing organizational environments and provides practical application possibilities for organizations.

Details

Qualitative Research in Organizations and Management: An International Journal, vol. 5 no. 1
Type: Research Article
ISSN: 1746-5648

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Article

Efthimia Pantzartzis, Andrew D.F. Price and Federica Pascale

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality…

Abstract

Purpose

This paper aims to identify costs related to dementia care provision and explore how purpose-built environment investments can help control these costs and improve quality of life and clinical outcomes.

Design/methodology/approach

This research adopts a multi-method approach where the findings of a literature review drove the analysis of data obtained from the 115 pilot projects funded by the Department of Health England’s National Dementia Capital Investment Programme.

Findings

Under the UK Government’s new productivity challenge, it is fundamental to identify actions that provide value for money to prioritise policy and practice. This paper identifies healthcare spaces (e.g. bathroom) where the impact of the built environment on healthcare costs are most evident and building elements (e.g. lighting) to which these costs can be directly associated. The paper advocates the development of evidence and decision support tools capable of: linking built environment interventions to the healthcare costs; and helping the healthcare and social care sectors to develop effective and efficient capital investment strategies.

Research Limitations/implications

Further work needs to develop more systematic ways of rationalising proactive and timely built environment interventions capable of mitigating dementia (and older people) care cost escalation.

Originality/value

This research takes an innovative view on capital investment for care environments and suggests that appropriate built environment interventions can have a profound impact on costs associated with dementia care provision.

Details

Journal of Financial Management of Property and Construction, vol. 21 no. 2
Type: Research Article
ISSN: 1366-4387

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Article

Muhammad Khalilur Rahman, Md Shah Newaz, Mina Hemmati and S M Yusuf Mallick

The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for…

Abstract

Purpose

The purpose of this study is to explore the private general practice (GP) clinics' service environment, patients' satisfaction and their impact on word of mouth (WoM) for others for future treatment in GP clinics.

Design/methodology/approach

Data are collected from 367 respondents using a paper-based survey questionnaire. Partial least square (PLS) is used to evaluate the proposed model and hypotheses relationships.

Findings

The findings reveal that ambience and service delivery have a high significant influence on patients' emotional satisfaction (β = 0.27, t = 4.31, p = 0.00) and (β = 0.26, t = 4.81, p = 0.00), respectively, while interior décor has a positive and significant influence on satisfaction (β = 0.13, t = 1.98, p = 0.04). The results indicate that exterior design and cleanliness are not associated with satisfaction. Patients' emotional satisfaction is highly related to WoM (β = 0.55, t = 13.44, p = 0.00). The results also show that emotional satisfaction has a significant mediating effect on the relationship between clinic service environments (ambience, interior décor, service delivery) and WoM (β = 0.15, t = 3.94, p = 0.00), (β = 0.073, t = 3.94, p = 0.04), (β = 0. 0.143, t = 4.13, p = 0.00), respectively.

Originality/value

The study will provide insights regarding Malaysian health consumers' perceptions toward GP clinics' service environment, whether they remain utilitarian or have evolved to entail hedonic appreciations. The contribution to the service environment could be adopted by future health-care studies, particularly those intended to examine GP clinics and other clinic-based institutions.

Details

Health Education, vol. 121 no. 3
Type: Research Article
ISSN: 0965-4283

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Book part

Jessica M. Ray, Rebecca Berg and Stephanie N. Sudikoff

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies…

Abstract

Changes in the physical environments of health care settings have become increasingly common to meet the evolving needs of the health care marketplace, new technologies, and infrastructure demands. Physical environment change takes many forms including new build construction, renovation of existing space, and relocation of units with little to no construction customization. The interrelated nature of the complex socio-technical health care system suggests that even small environmental modifications can result in system-level changes. Environmental modifications can lead to unintended consequences and introduce the potential for latent safety threats. Engaging users throughout the change lifecycle allows for iterative design and testing of system modifications. This chapter introduces a flexible process model, PROcess for the Design of User-Centered Environments (PRODUCE), designed to guide system change. The model was developed and refined across a series of real-world renovations and relocations in a large multihospital health care system. Utilizing the principles of user-centered design, human factors, and in-situ simulation, the model engages users in the planning, testing, and implementation of physical environment change. Case studies presented here offer exemplars of how to modify the model to support individual project objectives and outcomes to assess at each stage of the project.

Details

Structural Approaches to Address Issues in Patient Safety
Type: Book
ISBN: 978-1-83867-085-6

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Article

Jayne Brown, Yvonne Robb, Kathleen Duffy and Andrew Lowndes

This paper argues that all parties in care settings ‐ that is, older people and their carers, qualified and unqualified staff and students ‐ have learning needs, and that…

Abstract

This paper argues that all parties in care settings ‐ that is, older people and their carers, qualified and unqualified staff and students ‐ have learning needs, and that an appreciation of these needs is essential if high‐quality care and a positive work environment are to be achieved. It describes the rationale for, and the development of, the Profile of Learning Achievements in Care Environments (PLACE) approach. Building on the notions of relationship‐centred care and underpinned by the 'Senses Framework', PLACE seeks to provide a toolkit for identifying learning needs, establishing what seems to be working well and agreeing areas in need of improvement. The theory underpinning PLACE and the methodology for its development are described and potential areas for application are considered.

Details

Quality in Ageing and Older Adults, vol. 10 no. 3
Type: Research Article
ISSN: 1471-7794

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Book part

Heather Dillaway and Catherine Lysack

We explore the effects and interplay of physical and social environments on the inaccessibility of gynecological health care for women with spinal cord injury. We also…

Abstract

Purpose

We explore the effects and interplay of physical and social environments on the inaccessibility of gynecological health care for women with spinal cord injury. We also explore women’s responses to the inaccessibility of this care, in hopes of trying to understand better how women navigate their gynecological health and health care when faced with physical and social environmental constraints.

Design/methodology/approach

The data for this phenomenological study were gathered using in-depth, qualitative interviews with 20 women living with spinal cord injuries in or around Detroit, Michigan. Each interviewee was questioned about overall health and physical functioning, accessibility of doctor offices, interactions with health care providers, gynecological health-seeking behaviors, and complementary and alternative medicine use. In this paper we report on data on women’s difficulties in securing gynecological health care experiences and related attitudes and practices.

Findings

Findings echo past literature about the inaccessibility of doctor’s offices, including the lack of suitable exam tables and medical equipment. Office staff varied in their willingness to help transfer women from wheelchairs to exam tables as well, often creating what we term an inaccessible social environment. Individual women in our sample found different strategies for navigating the environmental contexts of a doctor’s office and the encounters that they had with providers within medical settings. These strategies had varying impacts on individuals’ abilities to secure gynecological health care.

Originality/value

Our findings point to the possibility of an interplay between and intersection of physical and social environments within medical settings that needs to be explored further and, potentially, the primary importance of the social environment over the physical environment in determining whether an individual’s disability makes health care inaccessible.

Details

Environmental Contexts and Disability
Type: Book
ISBN: 978-1-78441-262-3

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Article

Graydon Davison

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an…

Abstract

Purpose

To begin a process of understanding how palliative care organisations are configured to enable innovative multidisciplinary patient care teams and their management in an uncertain, complex and dynamic environment.

Design/methodology/approach

A range of literature was reviewed to suggest configuration and characteristics that were tested using semi‐structured interviews with the senior medical staff member at each of three Australian case study organisations. Data gathered from these interviews was supplemented with data gathered from semi‐structured interviews with multidisciplinary management teams and patient care teams dealing with inpatients and home‐care patients.

Findings

A hybrid configuration is suggested, based on Mintzberg's typology of organisations. Responses from interviews modify some characteristics of the suggested configuration, though generally appearing to support it. Characteristics of the external and internal environments are described.

Research limitations/implications

Palliative care is rarely written off outside the healthcare literature and comparatively infrequently within it. Configuration is used to suggest the characteristics of innovative teams in an uncertain, dynamic, complex environment. The use and management of multidisciplinary patient care teams in palliative care offers interesting insights for a broad range of organisations.

Practical implications

A contribution to the discourse on the relationship between configuration and innovation based in organisations without commercial imperative, delivering multi‐level care for and by people involved in the end‐of‐life process.

Originality/value

The paper continues a line of publications, beginning in 2002, describing the management of innovation in multidisciplinary palliative care teams. The originality and value of this paper and this line of research is in taking a management view of a unique environment that offers insights and lessons to a broad range of organisations.

Details

European Journal of Innovation Management, vol. 8 no. 2
Type: Research Article
ISSN: 1460-1060

Keywords

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