Search results

Advances in recombinant drug technology will impose pressure for swift action by decision‐makers who may be required to operate on the basis of very limited information. This paper is the by‐product of a recently initiated North Western Regional Health Authority interim procedure designed to give swift consideration to innovations, to provide additional information for decision‐makers and to permit both clinicians and decision‐makers to combine in ensuring that greater rationality is applied to the introduction of drug innovations than might otherwise be the case. It is envisaged that this procedure will be of equal value in other areas where new medicines may have major revenue consequences.

Reports a postal survey of NHS staff in six Districts in the North Western Region. There were 3,525 replies, from staff in five main occupational groups, with clear social gradients in respect of health status, smoking and exercise, but a more complex picture in respect of diet, stress and uptake of preventative services. There were no significant differences in respect of alchohol consumption. Previous research showed social class differences in mortality of NHS staff; this study documents aspects of lifestyle consistent with that. Although the importance of socio‐economic circumstances and social support should not be disregarded, the survey results emphasize the need for NHS managers to reduce the inequality in health experienced by NHS staff, working with ancillary staff as a priority.

The purpose of this viewpoint article is to acquaint those engaged in health care quality improvement and patient safety programs with an effective, well‐documented but overlooked method. As described in a 1978 article, “Achievable Benefit Not Achieved” (ABNA) is a formal, efficient, transdisciplinary, evidence‐based method to identify and prioritize quality improvement project topics.

Narrative review of personal experience and pertinent literature.

While the ABNA method succeeds in serving its purpose when applied, and no evidence could be found to discredit it, ABNA appears to have been abandoned and forgotten for reasons of political expediency.

A strength and weakness of this research is its reliance upon personal narratives from the limited number of individuals still available who have first‐hand knowledge of past events. Convergence of those narratives along common themes, and their consistency with published records, is reassuring; however, age, memory, and some reluctance to broach political barriers limit one's ability to examine key events of past decades. A structured interview format conducted by a trained and experienced interviewer who had no vested interests in the topic, plus independent analysis of transcripts by researchers who have experience in qualitative methods, protects internal validity of the work.

Today's emphasis on continuously improving the quality and safety of health care requires appropriately focused, effective programs. ABNA arose and was suppressed in an era when health service deficiencies characteristically remained hidden as potential embarrassments rather than sought out as opportunities for improvement. ABNA, that era's under‐appreciated tool, should be reconsidered for its unique merits to guide today's programs.

This work, one of the first efforts to trace the entire history of ABNA, confirms that the method remains practical, effective and has not been discredited.

To put forward the, to date, unidentified viewpoint that organisational action research and project management have many shared properties – making it a useful exercise to compare and contrast them in relation to organisational management structures and strategies.

A conceptual exploration, drawing on a wide range of supporting literature, is used here.

Project management represents a mainstay strategy for much of the organisational research seen in health care management – and has done for many years. More recently, the exploratory literature on project management has identified many limitations – especially when matched against “traditional” examples. Many health services have witnessed a more recent organisational management drive to seek out alternative strategies that incorporate less hierarchical and more participatory research methods. Action research certainly fits this bill and, on further examination, can be incorporated into a project management ethos and vice versa.

The views expressed here are of a theoretical construct and have not been implemented, as they are presented in this paper, in practice. The intention, however, is to do so in some of the author's future studies.

If the management of health service organisations are to evolve to incorporate desirable structures that promote consumer‐oriented empowerment and participation (where the consumers also include the workforce), then having a wider array of research tools at one's disposal is one way of facilitating this. Incorporating action research principles into project management approaches, or the other way round, or marrying them both to form a “hybrid” research strategy – it is argued here – represents an appropriate and representative way forward for future organisational management studies.

In terms of originality, this represents a conceptual piece of work that puts forward constructs that have, to date, not featured in the health care literature. Its value lies in suggesting further options for organisational‐oriented health care research.

Health at Work in the NHS was launched at the same time as Health of the Nation, in July 1992. There is good national and local evidence identifying ancillary staff as a priority for health promotion. Despite the evidence, and a regional drive to make work with ancillary staff a priority, a recent audit made clear that very little has happened. Market testing seems to have excluded ancillary staff health from senior management responsibility. Discusses possible reasons and the implications.

This paper explores the growing interest of Health Service researchers in evaluating processes or process evaluation and discusses the relevance of this type of evaluation to the National Health Service (NHS( in the UK. Increased focus has been given to issues of evidence‐based health care since the introduction of the NHS R&D strategy in 1991. Nevertheless, there is a need to understand complex ways of working, particularly as changes in practice rarely follow a linear pattern. The basic principles of process evaluation and its links to social science methodologies are outlined, including the importance of context and the role of stakeholders, and how process evaluation can assist health professionals in their work is explored. It is then shown how the process evaluations linked to four initiatives designed to promote evidence‐based decision making or change clinicians’ behaviour were crucial for understanding the reasons for the outcomes of the initiatives.

The “Peckham” initiative is introducing a coherent framework for research and development (R&D) in the UK National Health Service (NHS). This entails close collaboration between the universities and the health service. However, there are inherent weaknesses in the current ethos of research and academic which suggest that there may be little understanding of the needs of NHS decision makers. There is a danger if health service managers do not take control of the agenda for R&D that it will be subverted to serve narrow academic interests. Explores means by which this can be averted. Suggests that managers should control the strategy of R&D and through the use of checklists determine broadly the content of study protocols.

The so‐called Denver connection should be today’s shining example of how to achieve health care quality and safety improvement through lasting evidence‐based collaborations led by health professionals. Instead, this 30 year old experiment is all but forgotten and the story of its demise is a tale of destructive corporate growth. Unfortunately, it bears prescient similarity to problems in health care restructuring today. We should question whether today’s business models, management performance, and accreditation mandates have set the right stage before we venture forth to act again. Unless we ensure a better environment in which to operate, today’s “new” approaches for improving quality and safety may be doomed to the same sad fate.

Research suggests that 85 per cent of health research is avoidably wasted. The research and development management community has an important role in the research process and can contribute to improving the quality and value of research. Al-Shahi Salman et al. (2014) identified ways in which the community can contribute towards the reduction of research waste by increasing the efficiency of recruitment and retention of research participants, data management and data sharing in studies, and promoting the integration of research into practice. The paper aims to discuss these issues.

A project undertaken between May 2016 and May 2017 explored the perspective, and contribution, towards reducing research waste amongst the research and development management community. The study identified those categories of research waste the community felt were the most important and of the most value to address. It also examined spheres of influence and barriers to addressing research waste.

The most important and highest value categories of research waste to address were: implementation of research in practice, prioritisation of research, and design, conduct and analysis of research. The research and development management community’s level of influence in those areas was low. The categories where the community felt they had most influence, with the exception of design, conduct and analysis of research, were generally those they thought were less important and valuable, i.e. research taking place to time and target, public and patient involvement, and administration.

Waste in research is a significant area of waste in health care expenditure. This study has provided a better understanding of research waste for the research management community. The research and development management community can take a leadership role in formulating an action plan and identifying measures of success in reducing waste in research.

This paper aims to briefly describe the increasingly complex array of organizations influencing American healthcare‐associated infection (HAI) prevention efforts during the modern era of infection control.

This paper is a narrative review.

The modern era of hospital infection control began in the 1950s, but received relatively little publicity until the dawn of the twenty‐first century. Since then, there has been a wave of unprecedented magnitude in individual state legislation mandates followed by a shift from state to federal agency activity. The resulting programs are in varying stages of development, ability, sustainability, and coordination.

Many government and healthcare entities are in uncharted territory with this new area of activity, facing challenges in having to coordinate work with many new and unfamiliar partners. Perspectives explored in this part of the Universities Council Symposium help by mapping out the various stakeholders in order to foster a research agenda through better understanding of powerful political players and their influence.

This is one of the first efforts to describe and map the evolving range of state and federal forces influencing hospitals' efforts to prevent healthcare‐associated infections.