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Article
Publication date: 1 June 2000

N.V. Raynes

This article identifies the views of terminally ill patients with cancer about the palliative care services they receive and the value they put on these. A sample of 27…

Abstract

This article identifies the views of terminally ill patients with cancer about the palliative care services they receive and the value they put on these. A sample of 27 patients was drawn, and their views obtained using focus groups. This enabled the exploration of the patients’ own views of what services were important to them. The findings confirm that some services included in more structured questionnaires and interviews are ones that patients would spontaneously identify. These include better information, help with activities of daily living, and home‐care services. Macmillan nurses and GPs’ services are highly rated but not in all areas. The patients identify additional services as important to them. These are the provision of something to do, improved hospital visits and respite supports for their family carers. Differences identified across the three trust areas should make purchasers sensitive to variations in services valued by patients.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 4 March 2014

Laura Willets, Paul Mooney and Nicholas Blagden

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability…

Abstract

Purpose

The social climate of psychiatric institutions correlates with multiple outcomes related to staff and patients. Research into social climate in Learning Disability services is limited. Staff and patients in Learning Disability services have documented both positive and negative experiences. No research has directly compared the social climate of Learning Disability and non-Learning Disability psychiatric services. The purpose of this paper is to understand how these compare. The study will also compare staff and patient views of social climate and the impact of security on social climate in Learning Disability services.

Design/methodology/approach

A total of 64 patients and 73 staff, from Learning Disability and non-Learning Disability psychiatric hospitals completed the Essen Climate Evaluation Schema (EssenCES) measure of social climate.

Findings

Patients in Learning Disability and non-Learning Disability services did not differ in their perceptions of social climate. Staff in non-Learning Disability services had a more positive perception of social climate than staff in Learning Disability services. Patients and staff did not differ in their views on climate. Security was negatively related to patients’ Experienced Safety.

Originality/value

The findings suggest that staff perceive that the deficits associated with Learning Disabilities may limit patients’ therapeutic experience and relationships with their peers. Despite this, patients with Learning Disabilities feel supported by their peers, have positive views of the treatment process and feel as safe as non-Learning Disabled psychiatric patients.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 5 no. 1
Type: Research Article
ISSN: 2050-8824

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Article
Publication date: 1 July 1999

Christine Farrell

Reports on research carried out in 1997/98 which used four different methods in a staged process: literature review, in‐depth interviews, a postal questionnaire and focus…

Abstract

Reports on research carried out in 1997/98 which used four different methods in a staged process: literature review, in‐depth interviews, a postal questionnaire and focus groups in acute and primary care. There was a surprising level of agreement between patients, carers and NHS staff about what was wrong with the existing charter and about what a new charter should contain. Patients knew very little about the contents of the Charter. NHS staff were much more knowledgeable and much more critical of its impact on them and NHS services. The overall view was that it had been of limited usefulness. Although there were differences in emphasis, there was almost unanimous agreement about what a new charter should contain: it should be based on the principles of openness, accountability and equity; there should be a much stronger focus on primary and community health care; there should be clearer statements about patients’ rights of access to services; standards which focus on clinical need, effectiveness and health outcomes; and standards for better communication and information in a usable form. A new charter should emphasis the rights and responsibilities of patients and staff. Most important of all, patients and staff should be involved in the development of a new charter so that it will reflect their views.

Details

International Journal of Health Care Quality Assurance, vol. 12 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 8 May 2007

Elizabeth Smith and Fiona M. Ross

Understanding patients' experiences of their interactions with health services is an important step in building quality from within. The purpose of this article is to look…

Abstract

Purpose

Understanding patients' experiences of their interactions with health services is an important step in building quality from within. The purpose of this article is to look at the possibilities for involving service users in the development of the National Health Service in England through the structure of integrated care pathways (ICPs).

Design/methodology/approach

A systematic literature review was undertaken to identify how patient experiences have been attained and used in three clinical areas: cataract care, hip replacement and knee arthroscopy. The information was weighted according to methodological criteria and synthesized according to the typical stages of each pathway. Key issues were summarised thematically across each pathway.

Findings

The findings relate to the use of patient views and experiences within organisational structures, service development, methodological research, education and training. The article identifies important issues of practical significance for involving service users in the planning and development of patient focused ICPs: such as the diversity of patients, perspectives of continuity, information and patient support and the need for methodological research.

Research limitations/implications

The review is limited in that the literature across all three pathways tends to report findings of small studies undertaken in one clinical service or setting and most studies are not randomised or controlled.

Originality/value

The literature identified by the review contains important messages for both NHS policy and future research to involve service users in the planned expansion and plurality of NHS care.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 3
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 June 2004

Richard Fuller

Managing risk and making decisions presents an increasing challenge to doctors as they are encouraged to adopt a partnership approach with patients to dealing with risk…

Abstract

Managing risk and making decisions presents an increasing challenge to doctors as they are encouraged to adopt a partnership approach with patients to dealing with risk, within a “risk society” constructed around individuality, uncertainty, blame and responsibility. In‐depth interviews, stimulated by clinical vignettes, were used to explore the key position of doctors within this risk society. Analysis, sensitised through contemporary texts, revealed unexpected findings that portrayed doctors as reflexive jugglers of risk. Discourses in this study revealed indecision and uncertainty, balanced against needs to preserve professional roles and engage patients in addressing risk, whilst preventing widespread harm and conflict. In concluding, the alternative approaches to risk with older people will suggest a more trusting and positive process that presents a real opportunity for truly sharing risk and decisions that benefit both doctor and patient.

Details

Journal of Health Organization and Management, vol. 18 no. 3
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 27 March 2009

Karin Pukk Härenstam, Mattias Elg, Carina Svensson, Mats Brommels and John Øvretveit

The purpose of this paper is to survey Swedish healthcare leaders' patient safety awareness, the priority they give to safety issues and their views on suitable safety…

Abstract

Purpose

The purpose of this paper is to survey Swedish healthcare leaders' patient safety awareness, the priority they give to safety issues and their views on suitable safety management strategies.

Design/methodology/approach

A total 623 leaders of a sample of 1,129 responded to a mail questionnaire (55 percent response rate). Descriptive statistics of the responses are presented as frequency distributions across respondent subgroups. Means were tested for similarity by a repetitive one‐way ANOVA procedure. Homogeneous response groups were sought by hierarchical cluster analysis.

Findings

Swedish healthcare leaders show relatively high safety awareness and how their organizations prioritize safety management. There is a marked polarization between leaders; half feel that the system works reasonably well, and that adequate funds are available to improve or maintain services. The other half thinks the system needs major change and calls for additional funding. A majority sees system errors as the main cause for adverse events; a substantial minority find human errors to be more important. Two‐thirds were willing to make safety performance information on organizations and specialties public, one third was restrictive.

Research limitations/implications

Survey instruments used to explore leaders' patient safety views have not yet been rigorously tested against psychometric criteria. One hospital type was slightly over‐represented and three regions somewhat under‐represented in the respondent groups.

Originality/value

This is the first systematic attempt to explore the views of Swedish healthcare leaders on patient safety. It provides input to a national strategy to improve patient safety.

Details

International Journal of Health Care Quality Assurance, vol. 22 no. 2
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 2 August 2013

Margaret Flynn and Vic Citarella

This paper concerns the fall‐out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and…

Abstract

Purpose

This paper concerns the fall‐out from a TV programme which exposed the arbitrariness of cruelty at a private hospital that purported to provide assessment, treatment and rehabilitation to adults with learning disabilities, autism and mental health problems. The paper seeks to address the issues involved.

Design/methodology/approach

It describes the principal findings of a Serious Case Review which was commissioned after the TV broadcast, and outlines some of the activities designed to reduce the likelihood of such abuses recurring.

Findings

From policy, commissioning, regulation, management, service design and practice perspectives, events at Winterbourne View Hospital highlight a gulf between professionals, professionals and their organisations, and leadership shortcomings.

Originality/value

The English government responded promptly and encouragingly to the wretched circumstances of patients at Winterbourne View Hospital with a “Timetable of Actions”. The Serious Case Review which was commissioned after the TV broadcast contributed to the growing scepticism of “out of sight, out of mind” placements. It covered wide‐ranging territory.

Details

The Journal of Adult Protection, vol. 15 no. 4
Type: Research Article
ISSN: 1466-8203

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Article
Publication date: 9 February 2015

Simon Chu, Kimberley McNeill, Karen M. Wright, Anthony Hague and Tracy Wilkins

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service…

Abstract

Purpose

From 2012, all high-secure forensic mental health services in England began operating a policy of confining patients to their locked bedrooms overnight to increase service efficiency and reduce costs. The purpose of this paper is to assess the views of staff and patients concerning the policy and examine the specific impact of the policy on patients.

Design/methodology/approach

Measures of patients’ sleep hygiene, patients’ behaviour, ward atmosphere, engagement with therapy and adverse incidents were taken both before and after the night confinement (NC) policy was implemented. Both patients and staff also expressed their views of the impact of the NC policy.

Findings

Results provide converging evidence that the impact of the NC policy on patients is negligible. There were no consistent negative effects of confining patients overnight. Rather, patients and staff were broadly positive about the impact that the practice had on patients.

Practical implications

Confining patients to locked bedrooms overnight does not exert any consistent influence, positive or negative, on patients’ sleep hygiene, behaviour or engagement with therapy, and patients expressed a broadly positive view of the practice of NC. Thus, a NC policy may have a contribution to make to the provision an effective high-secure mental health service.

Originality/value

The study provides convincing evidence that secure inpatient mental health services that are considering the adoption of a NC policy may do so without fear of a negative impact on patients.

Details

Journal of Forensic Practice, vol. 17 no. 1
Type: Research Article
ISSN: 2050-8794

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Article
Publication date: 1 July 2000

Patrick Hill, Alex O’Grady, Bruce Millar and Kathryn Boswell

A number of approaches have been developed in recent years to try effectively to engage service users in the process of planning and delivering health‐care services. The…

Abstract

A number of approaches have been developed in recent years to try effectively to engage service users in the process of planning and delivering health‐care services. The consumerist methodology for the strategy described in this paper was designed to maximise staff involvement in capturing user views, in order to develop services at a district general hospital. This strategy – the Patient Care Development Programme (PCDP) – provides a framework for both staff and patient involvement in shaping and influencing the development of health‐care services. Uses the findings from applying the strategy to modify care packages, roles, skills, layouts, protocols and procedures, in response to both the “shortfalls” and the service strengths that the patient’s view uncovers. Discusses the results of an evaluation of the programme which has been replicated in another part of the UK. The PCDP now forms part of a clinical governance framework and is being used to develop multi‐agency integrated care pathways.

Details

International Journal of Health Care Quality Assurance, vol. 13 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 1 December 1994

Claire Batchelor, David J. Owens, Martin Read and Michael Bloor

Discusses how consumer evaluation studies of health‐care services mightbe undertaken to provide valid assessments of consumer opinions andpriorities, amenable to…

Abstract

Discusses how consumer evaluation studies of health‐care services might be undertaken to provide valid assessments of consumer opinions and priorities, amenable to subsequent, effective management action. To do so, provides an account of the history of patient satisfaction surveys, presents a detailed examination of key examples, and discusses the well‐documented strengths and weaknesses of this approach. Draws attention to recent critiques of survey methods and growing interest in qualitative research focusing on the rationale that the latter provides more useful data for managers. Argues that the search for a “best” consumer evaluation method is misplaced since appropriate methods should be determined by research objectives which themselves may vary. Points to existing analyses of relevant research which offer sound methodological guidelines and concludes by offering explicit suggestions for the future conduct of consumer evaluation research.

Details

International Journal of Health Care Quality Assurance, vol. 7 no. 7
Type: Research Article
ISSN: 0952-6862

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