An evaluation of a nurse led unit: an action research study

This study is an exemplar of working in a participatory way with members of the public and health and social care practitioners as co-researchers. A Nurse Consultant Older People working in a nurse-led bed, intermediate care facility in a community hospital acted as joint project lead with an academic researcher. From the outset, members of the public were part of a team of 16 individuals who agreed an evaluation focus and were involved in all stages of the research process from design through to dissemination. An extensive evaluation reflecting all these stakeholders’ preferences was undertaken. Methods included research and audit including: patient and carer satisfaction questionnaire surveys, individual interviews with patients, carers and staff, staff surveys, graffiti board, suggestion box, first impressions questionnaire, patient tracking and a bed census. A key aim of the study has been capacity building of the research team members which has also been evaluated. In terms of impact, the co-researchers have developed research skills and knowledge, grown in confidence, developed in ways that have impacted elsewhere in their lives, developed posters, presented at conferences and gained a better understanding of the NHS. The evaluation itself has provided useful information on the processes and outcomes of intermediate care on the ward which was used to further improve the service

The New York City Health and Hospitals Corporation: Transforming a Public Safety Net Delivery System to Achieve Higher Performance

Describes the results of the public benefit corporation's improvement initiatives -- a common clinical information system for continuity, coordination on chronic disease management, teamwork and continuous innovation, and access to appropriate care

Engaging with African American youth following gunshot wound trauma: The Calhoun Cultural Competency Course

African American youth comprise one-third of the 17,300 victims annually impacted by gun violence (National Center for Injury Prevention and Control, CDC, 2016). Injuries they sustain lead to extensive rehabilitation processes often overshadowed by the youths’ perceptions of discrimination and mistrust in medical staff, exacerbated by limitations in patient–provider communication and collaboration (Alston, Gayles, Rucker, &Hobson, 2007; Liebschutz et al., 2010). Healthcare staff often misinterpret youth gunshot survivors’ behavior and engagement efforts, labeling them noncompliant and implying they overexaggerate their pain. Overall, research suggests that African American patients do not have positive rehabilitation outcomes comparable to those of White patients (Suarez-Balcazar et al., 2009). Studies identify cultural competence, considered a best practice in healthcare professions, as a mitigating factor in this health disparity. The central aim of this doctoral project is to enhance patient–provider relationships to support optimal rehabilitation processes and outcomes and reduce this disparity. The Calhoun Cultural Competency Course (4C) was designed to address this urgent and profound problem according to a sound theoretical foundation and best evidence in cultural competency training. It is an online training on best practices for treating young African American gunshot-wound survivors. Course content and instruction methods were developed based on in-depth review of theories and evidence-based literature (Liebschutz et al., 2010; Teal, Gill, Green, & Crandall, 2012). Upon course completion, participants master skills necessary to provide care that is culturally sensitive, responsive, and appropriately tailored to these individuals’ needs, leading to more successful outcomes and community reintegration. The 4C program pilot is anticipated within 1 year of content completion. The program’s effectiveness in fostering change in participants’ cultural competency will be measured using a mixed-methods pre–post program evaluation design. First-year expenses include funding to support personnel during program-module development, create the online platform, and launch and evaluate the course pilot. The course moves forward in Year 3 with modifications and publishing pilot study results. Dissemination efforts will be written, electronic, and person-to-person methods with hopes of inspiring others to instill cultural competence training in their settings. Cultural competency training has potential to mitigate health disparities. The program described in this doctoral project aims to promote engagement of African American youth in rehabilitation following gunshot assault for better health and participation outcomes for them and their caretakers.