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Article
Publication date: 1 November 2023

Caroline Duncan, Ewan Wilkinson, Sujeet Jaydeokar and Daniel James Acton

This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National…

Abstract

Purpose

This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations.

Design/methodology/approach

The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records.

Findings

The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation.

Originality/value

To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 18 no. 1
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 6 May 2024

Augustino Mwogosi, Deo Shao, Stephen Kibusi and Ntuli Kapologwe

This study aims to assess previously developed Electronic Health Records System (EHRS) implementation models and identify successful models for decision support.

Abstract

Purpose

This study aims to assess previously developed Electronic Health Records System (EHRS) implementation models and identify successful models for decision support.

Design/methodology/approach

A systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The data sources used were Scopus, PubMed and Google Scholar. The review identified peer-reviewed papers published in the English Language from January 2010 to April 2023, targeting well-defined implementation of EHRS with decision-support capabilities in healthcare. To comprehensively address the research question, we ensured that all potential sources of evidence were considered, and quantitative and qualitative studies reporting primary data and systematic review studies that directly addressed the research question were included in the review. By including these studies in our analysis, we aimed to provide a more thorough and reliable evaluation of the available evidence.

Findings

The findings suggest that the success of EHRS implementation is determined by organizational and human factors rather than technical factors alone. Successful implementation is dependent on a suitable implementation framework and management of EHRS. The review identified the capabilities of Clinical Decision Support (CDS) tools as essential in the effectiveness of EHRS in supporting decision-making.

Originality/value

This study contributes to the existing literature on EHRS implementation models and identifies successful models for decision support. The findings can inform future implementations and guide decision-making in healthcare facilities.

Details

Journal of Health Organization and Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1477-7266

Keywords

Article
Publication date: 25 January 2021

Pouyan Esmaeilzadeh, Spurthy Dharanikota and Tala Mirzaei

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients…

Abstract

Purpose

Patient-centric exchanges, a major type of Health Information Exchange (HIE), empower patients to aggregate and manage their health information. This exchange model helps patients access, modify and share their medical information with multiple healthcare organizations. Although existing studies examine patient engagement, more research is required to investigate patients' attitudes and willingness to play an active role in patient-centered information exchange. The study's main objective is to develop a model based on the belief-attitude-intention paradigm to empirically examine the effects of patients' attitudes toward engagement in care on their willingness to participate in patient-centric HIE.

Design/methodology/approach

The authors conducted an online survey study to identify the antecedents and consequences of patients' attitudes toward engagement in care. To empirically test the research model, the authors collected data from a national sample (n = 357) of individuals in the United States. The data were analyzed using structural equation modeling (SEM).

Findings

The proposed model categorizes the antecedents to patients' attitudes toward engagement in patient-related and healthcare system factors. The results show that patient-related factors (perceived health literacy and perceived coping ability) and health system factors (perceived experience with the healthcare organization and perceived patient-provider interaction) significantly shape patient attitude toward care management engagement. The results indicate that patients' attitudes toward engaging in their healthcare significantly contribute to their willingness to participate in medical information sharing through patient-centric HIE initiatives. Moreover, the authors’ findings also demonstrate that the link between patient engagement and willingness to participate in HIE is stronger for individuals who perceive lower levels of privacy and security concerns.

Originality/value

The authors validate the proposed model explaining patients' perceptions about their characteristics and the healthcare system significantly influence their attitude toward engaging in their care. This study also suggests that patients' favorable attitude toward engagement can bring patient-centric HIE efforts onto a path to success. The authors’ research attempts to shed light on the importance of patients' roles in adopting patient-centric HIE initiatives. Theoretical and practical contributions of this study are noticeable since they could result in a deeper understanding of the concept of patient engagement and how it may affect healthcare services in an evolving digital world. The authors’ findings can help healthcare organizations provide public citizen-centric services by introducing user-oriented approaches in healthcare delivery systems.

Article
Publication date: 15 September 2023

Xin Yun Khor, Ai Ping Teoh, Ali Vafaei-Zadeh and Haniruzila Md Hanifah

With the function to store individual’s data input, personal health record (PHR) enhanced the accessibility to personal health information. This study aims to assess the factors…

Abstract

Purpose

With the function to store individual’s data input, personal health record (PHR) enhanced the accessibility to personal health information. This study aims to assess the factors that impact the intention of Malaysian internet users to use PHR and create a modified technology acceptance model (TAM) for eHealth.

Design/methodology/approach

Multivariate statistical analysis was performed on a total of 216 responses using the partial least square technique based on the cross-sectional survey among Malaysian internet users.

Findings

Behavioral intention was positively associated to PHR. Subjective norm significantly influenced both attitude and intention to use, whereas trust and perceived usefulness significantly influenced attitude. There was no significant positive impact in the relationships between compatibility and perceived ease of use and intention to use; nevertheless, they positively influenced perceived usefulness. Attitude exhibited mediating influence between trust, perceived usefulness and subjective norm and intention to use. Nonetheless, perceived risk did not affect behavioral intention. Thus, PHR acceptance was well-justified by the modified TAM in evaluating eHealth acceptance.

Practical implications

The eHealth vendors can enhance their marketing and development strategies on related products.

Originality/value

Literatures and empirical evidence on eHealth are still scarce, especially in emerging markets. The role of attitude may not be well-researched in health-care context, therefore was included in this study’s modified TAM. Critical determinants, namely, trust and risk, were added to the model.

Details

International Journal of Pharmaceutical and Healthcare Marketing, vol. 17 no. 4
Type: Research Article
ISSN: 1750-6123

Keywords

Article
Publication date: 26 March 2024

Dilek Şahin, Mehmet Nurullah Kurutkan and Tuba Arslan

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services…

Abstract

Purpose

Today, e-government (electronic government) applications have extended to the frontiers of health-care delivery. E-Nabız contains personal health records of health services received, whether public or private. The use of the application by patients and physicians has provided efficiency and cost advantages. The success of e-Nabız depends on the level of technology acceptance of health-care service providers and recipients. While there is a large research literature on the technology acceptance of service recipients in health-care services, there is a limited number of studies on physicians providing services. This study aims to determine the level of influence of trust and privacy variables in addition to performance expectancy, effort expectancy, social influence and facilitating factors in the unified theory of acceptance and use of technology (UTAUT) model on the intention and behavior of using e-Nabız application.

Design/methodology/approach

The population of the study consisted of general practitioners and specialist physicians actively working in any health facility in Turkey. Data were collected cross-sectionally from 236 physicians on a voluntary basis through a questionnaire. The response rate of data collection was calculated as 47.20%. Data were collected cross-sectionally from 236 physicians through a questionnaire. Descriptive statistics, correlation analysis and structural equation modeling were used to analyze the data.

Findings

The study found that performance expectancy, effort expectancy, trust and perceived privacy had a significant effect on physicians’ behavioral intentions to adopt the e-Nabız system. In addition, facilitating conditions and behavioral intention were determinants of usage behavior (p < 0.05). However, no significant relationship was found between social influence and behavioral intention (p > 0.05).

Originality/value

This study confirms that the UTAUT model provides an appropriate framework for predicting factors influencing physicians’ behaviors and intention to use e-Nabız. In addition, the empirical findings show that trust and perceived privacy, which are additionally considered in the model, are also influential.

Details

Journal of Science and Technology Policy Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2053-4620

Keywords

Article
Publication date: 16 April 2024

Sadia Zahid, Bushra Rauf, Rachel Lee, Hafsa Sheikh, Ashok Roy and Rani Pathania

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual…

Abstract

Purpose

A quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.

Design/methodology/approach

Data was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.

Findings

Most of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.

Originality/value

To the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 18 no. 2
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 28 February 2023

Helen Dion and Martin Evans

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that…

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Abstract

Purpose

The issue of energy efficiency is becoming increasingly prevalent globally due to factors such as the expansion of the population, economic growth and excessive consumption that is not sustainable in the long run. Additionally, healthcare facilities and hospitals are facing challenges as their operational costs continue to rise. The research aim is to develop strategic frameworks for managing green hospitals, towards energy efficiency and corporate governance in hospitals and healthcare facilities.

Design/methodology/approach

This research employs a qualitative case study approach, with a sample of ten hospitals examined through interviews with senior management, executives and healthcare facilities managers. Relevant data was also collected from literature and analysed through critical appraisal and content analysis. The research methodology is based on the use of grounded theory research methodologies to build theories from case studies.

Findings

The research developed three integrated conceptual strategic frameworks for managing hospitals and healthcare facilities towards energy efficiency, green hospital initiatives and corporate governance. The research also outlined the concepts of green hospitals and energy efficiency management systems and best practices based on the conclusions drawn from the investigated case studies.

Research limitations/implications

The study is limited to the initiatives and experiences of the healthcare facilities studied in the Middle East and North Africa (MENA) region.

Originality/value

The research findings, conclusions, recommendations and proposed frameworks and concepts contribute significantly to the existing body of knowledge. This research also provides recommendations for hospital managers and policymakers on how to effectively implement and manage energy efficiency initiatives in healthcare facilities.

Details

Benchmarking: An International Journal, vol. 31 no. 2
Type: Research Article
ISSN: 1463-5771

Keywords

Article
Publication date: 14 June 2023

Amit Desai, Giulia Zoccatelli, Sara Donetto, Glenn Robert, Davina Allen, Anne Marie Rafferty and Sally Brearley

To investigate ethnographically how patient experience data, as a named category in healthcare organisations, is actively “made” through the co-creative interactions of data…

Abstract

Purpose

To investigate ethnographically how patient experience data, as a named category in healthcare organisations, is actively “made” through the co-creative interactions of data, people and meanings in English hospitals.

Design/methodology/approach

The authors draw on fieldnotes, interview recordings and transcripts produced from 13 months (2016–2017) of ethnographic research on patient experience data work at five acute English National Health Service (NHS) hospitals, including observation, chats, semi-structured interviews and documentary analysis. Research sites were selected based on performance in a national Adult Inpatient Survey, location, size, willingness to participate and research burden. Using an analytical approach inspired by actor–network theory (ANT), the authors examine how data acquired meanings and were made to act by clinical and administrative staff during a type of meeting called a “learning session” at one of the hospital study sites.

Findings

The authors found that the processes of systematisation in healthcare organisations to act on patient feedback to improve to the quality of care, and involving frontline healthcare staff and their senior managers, produced shifting understandings of what counts as “data” and how to make changes in response to it. Their interactions produced multiple definitions of “experience”, “data” and “improvement” which came to co-exist in the same systematised encounter.

Originality/value

The article's distinctive contribution is to analyse how patient experience data gain particular attributes. It suggests that healthcare organisations and researchers should recognise that acting on data in standardised ways will constantly create new definitions and possibilities of such data, escaping organisational and scholarly attempts at mastery.

Details

Journal of Organizational Ethnography, vol. 12 no. 2
Type: Research Article
ISSN: 2046-6749

Keywords

Article
Publication date: 24 October 2023

Lucy Jade Jones and Ceri Woodrow

The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment…

Abstract

Purpose

The purpose of this clinical audit was to review the adherence to the 2017 care and treatment review policy across two NHS assessment and treatment units. Care and treatment reviews should be offered to people with an intellectual disability and/or autism who are at risk of admission into a mental health hospital.

Design/methodology/approach

Admission and discharge data was collected across two assessment and treatment units between January 2019 and December 2022. Adherence to the care and treatment review policy was also reviewed as was length of inpatient stay. A retrospective evaluation was conducted. Triangulation of data was collected via the trusts’ electronic patient record system and NHS analytics team. Descriptive statistics, Mann–Whitney U test and a one-way ANOVA with post hoc tests were used in the analysis.

Findings

An increase in behaviours of challenge and deterioration of mental health were the main reasons for admission. Forty-nine percent (30) of those admitted to the assessment and treatment units accessed a care and treatment review. Care and treatment reviews were more frequently provided for individuals experiencing longer inpatient stays.

Originality/value

There is limited evidence relating to outcomes and impact of care and treatment reviews. Further research is required to explore effectiveness of care and treatment reviews to understand benefits and appropriately prioritise resource.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 17 no. 4
Type: Research Article
ISSN: 2044-1282

Keywords

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