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Audit and feedback (A&F) often underlie implementation projects, described as a circular process; i.e. an A&F cycle. They are widely used, but effect varies with no apparent explanation. We need to understand how A&F work in real-life situations. The purpose of this paper, therefore, is to describe and explore mental healthcare full A&F cycle experiences.

This is a naturalistic qualitative study that uses four focus groups and qualitative content analysis.

Staff accepted the initial A&F stages, perceiving it to enhance awareness and reassure them about good practice. They were willing to participate in the full cycle and implement changes, but experienced poor follow-up and prioritization, not giving them a chance to own to the process. An important finding is the need for an A&F cycle facilitator.

Research teams cannot be expected to be involved in implementing clinical care. Guidelines will keep being produced to improve service quality and will be expected to be practiced. This study gives insights into planning and tailoring A&F cycles.

Tools to ease implementation are not enough, and the key seems to lie with facilitating a process using A&F. This study underscores leadership, designated responsibility and facilitation throughout a full audit cycle.

In North America, delegated practice “medical direction” models are often used as a proxy for clinical quality and safety in paramedic services. Other developed countries favor a combination of professional regulatory boards and clinical governance frameworks that feature paramedics taking lead clinician roles. The purpose of this paper is to bring together the evidence for medical direction and clinical governance in paramedic services through the prism of paramedic self-regulation.

This narrative synthesis critically examines the long-established North American Emergency Medical Services medical direction model and makes some comparisons with the UK inspired clinical governance approaches that are used to monitor and manage the quality and safety in several other Anglo-American paramedic services. The databases searched were CINAHL and Medline, with Google Scholar used to capture further publications.

Synthesis of the peer-reviewed literature found little high quality evidence supporting the effectiveness of medical direction. The literature on clinical governance within paramedic services described a systems approach with shared responsibility for quality and safety. Contemporary paramedic clinical leadership papers in developed countries focus on paramedic professionalization and the self-regulation of paramedics.

The lack of strong evidence supporting medical direction of the paramedic profession in developed countries challenges the North American model of paramedics practicing as a companion profession to medicine under delegated practice model. This model is inconsistent with the international vision of paramedicine as an autonomous, self-regulated health profession.

The 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.

This viewpoint paper focuses on three contributions: stakeholder engagement, using implementation science frameworks, and assessment of implementation strategies and outcomes.

Stakeholder 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.

Implementation 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.

Different 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.

Environmental social work (ESW) is an approach and a perspective in social work focusing on ecological and environmental sustainability and justice within the context of sustainable development (SD). This study aims to analyse students’ reflective tasks on challenges for ESW education and practice from a critical theory perspective. The purpose of this study is to discuss the implications of the findings for accelerating the implementation of SD in social work curricula.

The research participants comprised 49 master level students from four different cohorts studying the course “Social Work and Sustainable Development” at the University of Gävle, Sweden. The sample comprised only those students who had completed at least one of the three non-mandatory reflective tasks that were set within the course. The reflective tasks of the research participants were gathered as data for this study. A qualitative methodological approach with the help of ATLAS-ti V8.4 was used to analyse the gathered data.

This study discusses three primary results, which are categorised as “Being Boxed”, “Safe and Saviour Sweden” and “Politics and Power”. Based on the results, this study argues for a transformative and emancipatory pedagogy (TEP) in the teaching and learning of ESW to accelerate the implementation of holistic SD within the social work curriculum.

This study is mainly based on the analysis of “problematic” discourses of some of the students. The majority of the students and their respective discourses are not considered. Moreover, it would have been interesting, and probably enlightening to explore the background of the students (such as gender, ethnicity and religion) and any concomitant beliefs or prejudices (whether consciously held or otherwise) that would need to be addressed for an effective social work outcome. For ethical reasons, the background of the students was not recorded and analysed in this study.

Based on the results, this study argues for TEP in catalysing environmentalism within the social work curricula.

Social workers have a political mandate from their professional ethics to work for the protection of the planet and for the well-being of all – including non-humans. This study therefore argues for ESW education within social work curricula in promoting SD through social work practice.

Within the context of SD, there is a global call for social work education to shift from an anthropocentric to an eco-centric paradigm. However, ESW education is still in its infancy stage and very few universities are focusing in this particular area. This study therefore brings an important and well-needed layer of empirical evidence in considering the implications for catalysing environmentalism within the social work curricula.

The lack of critical thinking in new graduates has been a concern to the nursing profession. The purpose of this study was to investigate the effects of an innovative, evidence-based skills fair intervention on nursing students' achievements and perceptions of critical thinking skills development.

The explanatory sequential mixed-methods design was employed for this study.

The findings indicated participants perceived the intervention as a strategy for developing critical thinking.

The study provides educators helpful information in planning their own teaching practice in educating students.

As one ages, the risk of experiencing a fall increases and poses a number of serious consequences; 30 per cent of individuals over 65 years of age fall each year. Evidence-based falls prevention programmes demonstrate efficacy in reducing the rate and risk of falls among older adults, but their use in Irish occupational therapy practice is unknown. This study aims to investigate the implementation of falls prevention programmes by occupational therapists working with older adults in Ireland.

A cross-sectional survey was used to gather data on the use of falls prevention programmes among occupational therapists working with older adults in any clinical setting across Ireland. Purposeful, convenience and snowball sampling methods were used. The Association of Occupational Therapists of Ireland acted as a gatekeeper. Descriptive statistics and summative content analysis were used to analyse quantitative and qualitative data, respectively.

In all, 85 survey responses were analysed. Over 85 per cent of respondents reported “Never” using any of the evidence-based falls prevention programmes. The “OTAGO” Exercise Programme was the most “Frequently” used programme (9.5 per cent, n = 7); 29 respondents reported using “in-department” developed falls prevention programmes and 14 provided additional comments regarding current falls prevention practices in Ireland.

In the absence of Irish data on the subject, this study provides a benchmark to describe the use of evidence-based falls programmes by Irish occupational therapists with older adults.

Based on the theory of planned behavior (TPB) and stakeholder theory, the model proposes that responsible leadership (RL) is mediated by affective commitment (AC) on both outcome variables (organizational citizenship behavior [OCB] and patient satisfaction [PS]) while distributive justice (DJ) moderates the relationship among RL, OCB and PS through the mediator of AC.

Overall, data collected from 275 employees and patients in India’s healthcare sector support this model both in online and offline mode. SPSS 25, AMOS 22 and PROCESS macro were used to analyze the data.

The influence of RL, OCB and PS was seen insignificant in the Indian healthcare sector. This study examines the role of AC as a mediator which does not affect extra-role behavior and PS. The findings also show that the moderation-mediation effect of DJ through AC strengthened the link between RL and OCB, but not PS. Commitment does not affect extra-role behavior and PS.

Until now, there has been no research in the Indian context that has tested the effect of RL on extra-role behaviors and PS, as mediated by AC, according to researchers’ knowledge. Since RL and outcome variables are related through AC, the current study aims to understand how DJ acts as a moderator to that relationship.

Facilitation activities support implementation of evidence-based interventions within healthcare organizations. Few studies have attempted to understand how facilitation activities are performed to promote the uptake of evidence-based interventions in hospitals from resource-poor countries during crises such as pandemics. This paper aims to explore facilitation activities by infection prevention and control (IPC) professionals in 16 hospitals from 9 states in Brazil during the COVID-19 pandemic.

Primary and secondary data were collected between March and December 2020. Semi-structured interviews were conducted with 21 IPC professionals in Brazilian hospitals during the COVID-19 pandemic. Public and internal documents were used for data triangulation. The data were analyzed through thematic analysis technique.

Building on the change response theory, this study explores the facilitation activities from the cognitive, behavioral and affective aspects. The facilitation activities are grouped in three overarching dimensions: (1) creating and sustaining legitimacy to continuous and rapid changes, (2) fostering capabilities for continuous changes and (3) accelerating individual commitment.

During crises such as pandemics, facilitation activities by IPC professionals need to embrace all the cognitive, behavioral and affective aspects to stimulate positive attitudes of frontline workers toward continuous and urgent changes.

This study provides unique and timely empirical evidence on the facilitation activities that support the implementation of evidence-based interventions by IPC professionals during crises in hospitals in a resource-poor country.

Information is scarce on healthcare managers' understanding of simulation educators' impact on clinical work. Therefore, the aim of this study was to explore healthcare managers' perceptions of the significance of clinically active simulation educators for the organisation.

Healthcare managers were invited to be interviewed in a semi-structured manner. Inductive thematic analysis was used to identify and analyse patterns of notions describing the managers' perceptions of simulation educators' impact as co-workers on their healthcare organisations.

The identified relevant themes for the healthcare unit were: (1) value for the manager, (2) value for the community and (3) boundaries. Simulation educators were perceived to be valuable gatekeepers of evidence-based knowledge and partners in leadership for educational issues. Their most prominent value for the community was establishing a reflective climate, facilitating open communication and thereby improving the efficacy of teamwork. Local tradition, economy, logistics and staffing of the unit during simulation training were suggested to have possible negative impacts on simulation educators' work.

The findings might have implications for the implementation and support of simulation training programs.

Healthcare managers appreciated both the personal value of simulation educators and the effect of their work for their own unit. Local values were prioritised versus global. Simulation training was valued as an educational tool for continual professional development, although during the interviews, the managers did not indicate the importance of employment of pedagogically competent and experienced staff.

The study provided new insights about how simulation educators as team members affect clinical practice.

This study aims to describe how person-centred care, as a concept, has been adopted into discourse in 23 European countries in relation to their healthcare systems (Beveridge, Bismarck, out of pocket).

A literature review inspired by the SPICE model, using both scientific studies (CINHAL, Medline, Scopus) and grey literature (Google), was conducted. A total of 1,194 documents from CINHAL (n = 139), Medline (n = 245), Scopus (n = 493) and Google (n = 317) were analysed for content and scope of person-centred care in each country. Countries were grouped based on healthcare systems.

Results from descriptive statistics (percentage, range) revealed that person-centred care was most common in the United Kingdom (n = 481, 40.3%), Sweden (n = 231, 19.3%), the Netherlands (n = 80, 6.7%), Northern Ireland (n = 79, 6.6%) and Norway (n = 61, 5.1%) compared with Poland (0.6%), Hungary (0.5%), Greece (0.4%), Latvia (0.4%) and Serbia (0%). Based on healthcare systems, seven out of ten countries with the Beveridge model used person-centred care backed by scientific literature (n = 999), as opposed to the Bismarck model, which was mostly supported by grey literature (n = 190).

Adoption of the concept of person-centred care into discourse requires a systematic approach at the national (politicians), regional (guidelines) and local (specific healthcare settings) levels visualised by decision-making to establish a well-integrated phenomenon in Europe.

Evidence-based knowledge as well as national regulations regarding person-centred care are important tools to motivate the adoption of person-centred care in clinical practice. This could be expressed by decision-making at the macro (law, mission) level, which guides the meso (policies) and micro (routines) levels to adopt the scope and content of person-centred care in clinical practice. However, healthcare systems (Beveridge, Bismarck and out-of-pocket) have different structures and missions owing to ethical approaches. The quality of healthcare supported by evidence-based knowledge enables the establishment of a well-integrated phenomenon in European healthcare.

Our findings clarify those countries using the Beveridge healthcare model rank higher on accepting/adopting the concept of person-centered care in discourse. To adopt the concept of person-centred care in discourse requires a systematic approach at all levels in the organisation—from the national (politicians) and regional (guideline) to the local (specific healthcare settings) levels of healthcare.