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This study aims to explore the empirical correlation between patient flow issues, quality of green health services and patient satisfaction in specialist medical department factors from patients’ perspectives as service consumers.

This research is a type of nonintervention empirical research that uses an open survey to explore the views and experiences of users of specialist medical department services. The targeted population is hospital patients included in the top five national PERSI (Indonesian Hospital Association) Award 2022 Green Hospital Category, with a total number of respondents of 572 people. This study uses the partial least square-structural equation modeling analysis method with the SmartPLS application.

Patient flow problems generally affect the quality of eco-friendly health services, except for the waiting time problem, which affects service quality. It should be understood as a top priority for patients to receive services from medical specialists without risking time as a core service aspect from the patient’s perspective. In addition, all variables in eco-friendly hospital services affect patient satisfaction, except in the case of visits to specialist medical departments, which do not affect medical support services and hospital practices that are responsive to the delivery of care services resulting from medical support services that are inseparable in integrated services as well as health care following medical ethics.

This study has a novelty in understanding the implications of green practice in determining patient satisfaction in medical specialist department as the epicenter of hospital services and the main object of assessment for the quality of hospital services.

A region’s transforming care partnership identified that autistic adults without an intellectual disability (ID) may be falling through gaps in services when presenting with a significant emotional and/or behavioural need in the absence of a mental health diagnosis. The region’s intensive support teams (ISTs) for adults with ID therefore piloted a short-term “behavioural support service” for this population. The purpose of this paper is to evaluate this pilot.

This study represents a mixed-methods service evaluation over a four year pilot period. The quantitative component examined referral rates and demographic data of accepted and declined referrals; and length of referral episodes and Health of The Nation Outcomes Scores (HoNOS) for accepted referrals. The qualitative component used thematic analysis to identify key themes relating to reasons for referral, clinical/therapeutic needs, and the models of support that most informed assessments and interventions at individual and systems levels.

The ISTs accepted 30 referrals and declined 53. Most accepted referrals were male (83%), and under 24 years old (57%). Average HoNOS scores were above the thresholds generally associated with hospital admission. Key qualitative themes were: transitional support; sexual risks/vulnerabilities; physical aggression; domestic violence; and attachment, trauma and personality difficulties. Support mostly followed psychotherapeutic modalities couched in trauma, attachment and second- and third-wave cognitive behavioural therapies. Positive Behaviour Support (PBS) did not emerge as a model of preference for service users or professionals.

This project represents one of the first of this type for autistic adults without an ID in the UK. It provides recommendations for future service development and research, with implications for Transforming Care policy and guidance.

The purpose of this paper is to outline what early support should be offered to children and young people with neurodevelopmental conditions including those who are autistic or have intellectual disability. A review of all child and adolescent mental health services (CAMHS) services in the Northwest completed by NHS England and Improvement (Doyle and Ryan, 2021) found that there was no clear Tier 2 offer (for mild to moderate mental health issues) for autistic children and young people or for those with intellectual disability. Following this review, a project group that had developed a model for mental health services for autistic children and young people and for those with intellectual disability (Wee et al., 2021) was tasked with articulating the “Getting Help” offer for children and young people with neurodevelopmental conditions, including intellectual disability.

A working group was created consisting of professionals from mental health, education and local authority and lived experience representatives of coproduction partners. A brief review of the background literature was also conducted. Six meetings were held to create a framework for the “Getting Help” offer and to discuss what the offer should be based on professional expertise and lived experience.

Recommendations for the Getting Help multi-agency offer included pre- and post-assessment support as part of a single attention deficit hyperactivity disorder/autism/neurodevelopmental pathway, community support for children with intellectual disability, access to adapted mental health support and the need for early recognition and support for avoidant and restrictive food intake disorder. Key themes from working group discussions included the reduction in the quality of services experienced by children and families due to silo working, which increased the risk of falling between multi-agency services and led to early signs of neurodevelopmental needs, or mental health issues being missed. Another theme was aiming for equity of access and outcomes.

This work is a response to a coproduced review of CAMHS in the Northwest and incorporates the lived experience of young people and families. It also adopts a holistic multi-agency neurodevelopmental approach rather than focusing on a single diagnosis or service.

Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.

The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.

The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.

This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.

This paper aims to provide insights into the potential of digital technologies-based innovations for more inclusive healthcare by alleviating the affordability, accessibility and availability barriers to utilization of healthcare services. Also, it aims to provide insights into the potential of digital technologies-based innovations for more inclusive services, broadly.

A conceptual framework is inductively developed by analyzing real-world examples of digital technologies-based innovations for more inclusive healthcare through the lenses of economics of information in digital form and certain characteristics of services.

Concurrent implementation of digital technologies-based healthcare innovations with innovations and/or modifications in service processes can enable greater inclusivity by alleviating the affordability, accessibility and availability barriers to utilization of healthcare services.

Issues relating to inequities in healthcare, as a social problem, are the focus of research at multiple levels (e.g. global, national, regional and local) in several academic disciplines. In relation to the scope of the problems and challenges pertaining to providing quality healthcare to the unserved and underserved segments of society, worldwide, the contribution of the proposed framework to practice is modest. However, by highlighting the promise and potential of digital technologies-based innovations as solutions for alleviating barriers to affordability, accessibility and availability of healthcare services during various stages (prevention, detection, diagnosis, treatment and post-treatment follow-up) with illustrative vignettes and developing a framework, the article offers insights for future research. For instance, in reference to mission-driven social enterprises that operate in the product-market space for inclusive innovations under resource constraints, a resourcefulness-based view of the social enterprise constitutes a potential avenue for theory development and research.

Given the conceptual nature of the article, the implications for practice are limited to cognitive implications. Action implications (instrumental implications or implications for practice) are outside of the scope of the article.

Innovations that are economically viable, environmentally sustainable and socially impactful is one of the important issues of our times.

The proposed framework provides insights into the potential of digital technologies-based innovations for more inclusive healthcare by alleviating the affordability, accessibility and availability barriers in the context of emerging and less developed country markets and base of the pyramid segments of society in these markets.

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.

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.

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.

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

This paper aims to introduce the concept of using the well-established Shared Lives approach to support survivors of domestic abuse with complex needs including those with learning and physical disabilities, older people and carers.

Survivors with complex needs are often excluded from traditional domestic abuse support services thus increasing their risk and making recovery impossible. Using the Shared Lives approach in suitable cases could address gaps in provision and improve the outcomes for survivors with disabilities, older survivors and carers.

The paper draws on evidence from reports and research about the experiences of these cohorts of survivors to explain how the Shared Lives approach could increase support options for specific categories of survivors.

Using the Shared Lives approach to support cohorts of victims/survivors who experience barriers to accessing support could improve outcomes for these people, reduce risk of serious harm and improve quality of life.

With the recent recommendation from Association of Directors of Adult Social Services around increasing use of Shared Lives, this paper provides one potential way to meet this recommendation.

This study aims to explore how young people in child and adolescent mental health services (CAMHS) in the UK, Ireland, The Netherlands and Croatia, experienced leaving CAMHS and identified a range of factors impeding optimal discharge or transition to adult mental health services (AMHS).

Interviews about discharge or transition planning, including what information was provided about their ongoing mental health needs, undertaken with 34 young people aged 17–24, all previous or current attendees of CAMHS. Some interviews included accounts by parents or carers. Data were thematically analysed.

A number of previously well-documented barriers to a well-delivered discharge or transition were noted. Two issues less frequently reported on were identified and further discussed; they are the provision of an adequately explained, timely and appropriately used diagnosis and post-CAMHS medication management. Overall, planning processes for discharging or transitioning young people from CAMHS are often sub-optimal. Practice with regard to how and when young people are given a diagnosis and arrangements for the continuation of prescribed medication appear to be areas requiring improvement.

Study participants came from a large cohort involving a wide range of different services and health systems in the first pan-European study exploring the CAMHS to adult service interface. Two novel and infrequently discussed issues in the literature about young people’s mental health transitions, diagnosis and medication management were identified in this cohort and worthy of further study.

How can large international financial firms go green in authentic ways? What enhances ‘Net Zero action’? Changes in global banks, fund managers, and insurance firms are at the heart of green finance. External change pressures – combined with problematic firm predispositions – exacerbate barriers to change and promote scepticism about authentic Net Zero change. Field research reveals main elements, connections, and interactions of this question by considering financial firms as complex socio-technical systems (Mitleton-Kelly, 2003). An interdisciplinary/holistic narrative approach (De Bakker et al., 2019) is adopted to design a conceptual framework that can support a green ‘behavioural theory of the financial firm’ (green BTFF). The BTFF presents an international version (Peng, 2001) of the resource-based view (RBV) of the firm (Barney, 1991; Hart, 1995; Teece et al., 1997).

The approach of this chapter is aimed at closing knowledge gaps and realign values in financial markets and society. By raising awareness about organised hypocrisy and facades (Brunsson, 1993; Cho et al., 2015; Schoeneborn et al., 2020) in financial firms the chapter aims at overcoming the gap between ‘talking’ and ‘walking’ in the financial sector. The chapter defines testable firm-level hypotheses for ‘Green Finance’ (Poterba, 2021) as well as – by implication – tests for ‘greenwashing’.

The purpose of this paper is to develop an understanding of the experience of secure care from the patients’ perspective.

A systematic review of qualitative literature was conducted. The data was sourced from the electronic databases: PsychINFO, CINAHL, Medline and the Web of Science Core Collection using pre-defined search terms. A total of 17 studies, conducted in various countries worldwide and covering high, medium and low secure inpatient settings, were included for review. The analysis involved integrating findings from across the literature and was guided by thematic synthesis.

A total of eight themes were generated from the data, three of which provided an understanding of the experience of forensic secure care, and the remaining five themes provided an understanding of the factors which may influence the experience of secure care.

Developing understanding of patient experience can lead to service improvements, potentially impacting patients’ motivation and engagement and thus reducing admission times, potential recalls and recidivism.

To the best of the authors’ knowledge, this is the first systematic review to date to exclusively explore the broad topic of the patient experience of secure mental health care.