Search results

1 – 10 of 129
To view the access options for this content please click here
Article

Russell Linwood, Gary Day, Gerrard FitzGerald and Brian Oldenburg

The purpose of this article to review the literature relating to improving paramedic care in an Australian context.

Abstract

Purpose

The purpose of this article to review the literature relating to improving paramedic care in an Australian context.

Design/methodology/approach

The paper presents changes and challenges that have occurred in the ambulance services in terms of improving care and measuring performance, exploring the literature on quality improvement initiatives and their application to pre‐hospital care.

Findings

While hospitals and health services have moved well down the quality improvement pathway, the application of these processes to pre‐hospital care has been a relatively recent phenomenon. Ambulance services have taken a variety of approaches to measuring and improving pre‐hospital care. This article questions the transferability of lessons learned in hospitals to ambulance services. Arguably, the quality improvement approach is dependent upon health control and funding models and where ambulance is categorised in terms of health or emergency services.

Originality/value

The quality improvement approach by Australian paramedics and ambulance services is in its infancy. This article provides insights into the quality improvement approach taken by ambulance staff in Australia compared to other countries, as well as highlighting useful information on the future direction and research into the area.

Details

International Journal of Health Care Quality Assurance, vol. 20 no. 5
Type: Research Article
ISSN: 0952-6862

Keywords

To view the access options for this content please click here
Article

Joanna M. Blodgett, Duncan Robertson, David Ratcliffe and Kenneth Rockwood

With the increasing demand on ambulance services, paramedics are tasked to arrange as much out of hospital care as possible, to develop integrated systems of care and work…

Abstract

Purpose

With the increasing demand on ambulance services, paramedics are tasked to arrange as much out of hospital care as possible, to develop integrated systems of care and work with hundreds of different providers – all in the 15 minutes allocated for assessment. A UK ambulance trust is navigating and leading much of this work as one of the first trusts to implement a general practitioner referral policy as an alternate to direct conveyance. The paper aims to discuss this issue.

Design/methodology/approach

Here the authors discuss the referral scheme, examine the limited evidence available and discuss what is needed to influence prospective success of implementing this scheme in other trusts.

Findings

Limited evidence for these schemes are described, however there is a clear gap in critical appraisal and methodologically rigorous evidence needed to implement these schemes in other ambulance schemes.

Originality/value

In order to facilitate collaboration of healthcare services and to minimize the burden of increasing numbers of patients, communication and discussion of alternate routes of care is crucial. This viewpoint piece is one of the first to emphasize the potential benefits of such schemes.

Details

International Journal of Emergency Services, vol. 6 no. 2
Type: Research Article
ISSN: 2047-0894

Keywords

To view the access options for this content please click here

Abstract

Details

The Handbook of Road Safety Measures
Type: Book
ISBN: 978-1-84855-250-0

To view the access options for this content please click here
Article

David G. Ellis

The traditional principles of the ambulance service have served to underpin developments in pre‐hospital care, which together with increasing skills of paramedics and…

Abstract

The traditional principles of the ambulance service have served to underpin developments in pre‐hospital care, which together with increasing skills of paramedics and technology have both raised the profile of the service and arguably contributed to improvements in patient care. However despite these advances patients are still transferred to hospital following treatments from paramedic responses to ‘999’ emergencies. Evidence from the on‐scene treatment of diabetics suggests that certain patient groups can be appropriately managed in the community without recourse to either secondary or primary care through increasing paramedic judgement skills. Although this alone may not be enough to encourage support from health care professionals, the development of pre‐hospital care pathways with strict clinical and non‐clinical criteria may provide the answer. Increasing demands on all disciplines of the health service are to some extent determining the pace at which professionals work in finding solutions to more clinically effective care. The following paper offers a hypothesis that could potentially integrate paramedics more fully into the health care system.

Details

Journal of Clinical Effectiveness, vol. 3 no. 4
Type: Research Article
ISSN: 1361-5874

Content available
Article

Abstract

Details

Industrial and Commercial Training, vol. 48 no. 7
Type: Research Article
ISSN: 0019-7858

To view the access options for this content please click here
Article

Polly Christine Ford-Jones and Tamara Daly

Paramedics increasingly attend to mental health-related emergencies; however, there has been little evaluation of the mental health training for paramedics. This study…

Abstract

Purpose

Paramedics increasingly attend to mental health-related emergencies; however, there has been little evaluation of the mental health training for paramedics. This study aims to analyze the fit between paramedicine pedagogy, patient needs and the conditions for paramedics’ skill development.

Design/methodology/approach

Data were collected in a single, qualitative, critical ethnographic case study of pre-hospital mental health and psychosocial care in paramedicine in Ontario, Canada. Transcripts from interviews (n = 46), observation (n ∼ 90h) and document analysis were thematically analyzed using a constant comparative method. The study is theoretically grounded in a feminist political economy framework.

Findings

Tensions are explored in relation to the pedagogy of paramedicine and the conditions of work faced by paramedics. The paper presents challenges and insufficiencies with existing training, the ways in which certain work and training are valued and prioritized, increased emergency care and training needs and the limitations of training to improving care.

Research limitations/implications

Recommendations include more comprehensive didactic training, including the social determinants of health; scenario training; practicum placements in mental health or social services; collaboration with mental health and social services to further develop relevant curriculum and potential inclusion of service users.

Originality/value

This paper addresses the lack of mental health pedagogy in Ontario and internationally and the need for further training pre-certification and while in the workforce. It presents promising practices to ameliorate mental health training and education for paramedics.

Details

The Journal of Mental Health Training, Education and Practice, vol. 15 no. 6
Type: Research Article
ISSN: 1755-6228

Keywords

To view the access options for this content please click here
Article

Inger Johanne Pettersen, Kari Nyland and Geraldine Robbins

The purpose of this paper is to study the links between contextual changes, contract arrangements and resultant problems when changes in outsourcing regulatory…

Abstract

Purpose

The purpose of this paper is to study the links between contextual changes, contract arrangements and resultant problems when changes in outsourcing regulatory requirements are applied to complex pre-hospital services previously characterized by relational contracting.

Design/methodology/approach

The study deployed a qualitative design based on interviews with key informants and extensive studies of documents. It is a longitudinal study of a procurement process taking place in a regional health authority covering the period 2006 to 2017.

Findings

A complex and longitudinal public procurement process where pre-hospital (ambulance) services are transformed from relational and outsourced governance to more formal arrangements based on legal and transactional controls, is described in detail. After several years, the process collapsed due to challenges following public scrutiny, legal actions and administrative staff resignations. The public body lacked procurement competencies and the learning process following the regulations was lengthy. In the end, the services were in-sourced.

Research limitations/implications

This study is based on one case and it should, therefore, not be generalized without limitations.

Practical implications

One practical implication of this study is that transactional contracts are not optimal when core and complex services are produced in inter-organizational settings. In public sector health-care contexts, the role of informal and social controls based on relational exchanges are particularly applicable.

Social implications

Acute health-care services essential to citizens’ security and health imply high asset specificity, frequency and uncertainty. Such transactions should according to theory be produced in-house because of high agency costs in the procurement process.

Originality/value

The paper contributes to the understanding of how the public procurement process can itself be complex, as managerial challenges and solutions vary along several dimensions and are contingent upon external factors. In particular, the study increases knowledge of why the design and implementation of outsourcing models may create problems that impede and obstruct control in a particular public sector context.

Details

Journal of Public Procurement, vol. 20 no. 4
Type: Research Article
ISSN: 1535-0118

Keywords

To view the access options for this content please click here
Book part

Manolis Tsiknakis, Angelina Kouroubali, Dimitris Vourvahakis and Stelios C. Orphanoudakis

The rising of chronic illness and the continuous aging of the global population requires a re-organization of health care systems based on relations and exchange of…

Abstract

The rising of chronic illness and the continuous aging of the global population requires a re-organization of health care systems based on relations and exchange of information to address patient needs in the community. The re-organization of health care systems involves interconnected changes and the development of integrated health care information systems and novel eHealth services. In Crete, the Foundation for Research and Technology-Hellas has developed HYGEIAnet, a Regional Health Information Network (RHIN) to contribute to the re-organization of health care systems and information sharing. We present HYGEIAnet, some of the most critical and novel eHealth services developed and deployed, discuss the impact of an RHIN on health care processes, and explore innovative models and services for health delivery and the coordination of care. We then critically discuss lessons learned regarding the effective management of change to overcome organizational and cultural issues in such large-scale initiatives. The paper concludes with policy and practice recommendations for managing change processes in health care organizations.

Details

International Health Care Management
Type: Book
ISBN: 978-0-76231-228-3

To view the access options for this content please click here
Article

Caroline Waks

The purpose of this paper is to investigate whether, or to what extent, the audit society influences the professional context of Swedish pre‐hospital care.

Abstract

Purpose

The purpose of this paper is to investigate whether, or to what extent, the audit society influences the professional context of Swedish pre‐hospital care.

Design/methodology/approach

Data were collected through an in‐depth case study of public supervision within ambulance services in Sweden. A three‐dimensional framework departing from three analytical concepts (knowledge base, formal organization and operational process) was used as a tool for further analysis of the field material.

Findings

The paper describes ambulance services under the pressure of frequent audits in a context where the knowledge base of ambulatory work was contested. While some have argued this would make it more receptive to an audit culture, the relational distance between the auditor and the auditees was high, which should indicate the opposite.

Originality/value

The paper explores the audit society and its processes. In this particular case, it could be argued that the impact of an audit culture on professional activities was moderated by the dissociated approach of the auditing team.

Details

International Journal of Public Sector Management, vol. 22 no. 1
Type: Research Article
ISSN: 0951-3558

Keywords

To view the access options for this content please click here
Article

Annemaree Lloyd

The purpose of this paper is to present findings of an enquiry into the use and experience of information, in learning to become an ambulance officer. The paper aims to…

Abstract

Purpose

The purpose of this paper is to present findings of an enquiry into the use and experience of information, in learning to become an ambulance officer. The paper aims to explore how the information environment is constituted for novice and experience practitioners. The paper also aims to consider what type of information is considered important by novice and experienced practitioners in learning about practice and profession.

Design/methodology/approach

The study is approached from an information literacy (IL) perspective, where IL is viewed as the catalyst for learning about work and professional practice. It draws on constructivist‐influenced grounded theory method to explore how an IL experience is constituted for the worker.

Findings

Three modalities of information which inform practice are described. IL is illustrated as more than just an experience with text or skills‐based literacy. It is viewed as socio‐cultural practice which is shaped by discourse.

Research limitations/implications

The research was limited to an in‐depth exploration of one professional group in one geographic location.

Practical implications

The study highlights the value of an IL approach to understanding how information is experienced in a workplace context.

Originality/value

This paper reports original research of significance to information professionals and educators.

Details

Journal of Documentation, vol. 65 no. 3
Type: Research Article
ISSN: 0022-0418

Keywords

1 – 10 of 129