Towards a framework to study influence and accounting use.

The autonomous regions of Spain have responsibility for healthcare. The Galician Health Service aims to achieve a higher level of health for Galicians with an appropriate primary healthcare system. The law requires healthcare to be promoted within a system of participative management directed by an upper level of management. The healthcare system is changing, and the upper level managers are introducing new systems to improve the provision and administration of care. These changes will include the provision of accounting data in the normal course of managing. This paper is before a study of the changes. The paper provides the background to constructing a Framework and then constructs a Framework for our empirical work. It uses the constructs of information and influence with markers of the information areas and styles of influence in the form of an Information–Influence Matrix (Purdy, 1993b). It also uses personal construction (Kelly, 1955) to help create a dynamic approach to change and the use of accounting information. It finally provides a framework of our anticipations of what might happen to a Health Centre Manager and an Upper Manager.

Informing the development of services supporting self-care for long term mental health conditions: A mixed method study of community based mental health initiatives in England

Background Supporting self-care is being explored across health care systems internationally as an approach to improving care for long term conditions in the context of ageing populations and economic constraint. UK health policy advocates a range of approaches to supporting self-care, including the application of generic self-management type programmes across conditions. Within mental health, the scope of self-care remains poorly conceptualised and the existing evidence base for supporting self-care is correspondingly disparate. This paper aims to inform the development of support for self-care in mental health by considering how generic self-care policy guidance is implemented in the context of services supporting people with severe, long term mental health problems. Methods A mixed method study was undertaken comprising standardised psychosocial measures, questionnaires about health service use and qualitative interviews with 120 new referrals to three contrasting community based initiatives supporting self-care for severe, long term mental health problems, repeated nine months later. A framework approach was taken to qualitative analysis, an exploratory statistical analysis sought to identify possible associations between a range of independent variables and self-care outcomes, and a narrative synthesis brought these analyses together. Results Participants reported improvement in self-care outcomes (e.g. greater empowerment; less use of Accident and Emergency services). These changes were not associated with level of engagement with self-care support. Level of engagement was associated with positive collaboration with support staff. Qualitative data described the value of different models of supporting self-care and considered challenges. Synthesis of analyses suggested that timing support for self-care, giving service users control over when and how they accessed support, quality of service user-staff relationships and decision making around medication are important issues in supporting self-care in mental health. Conclusions Service delivery components – e.g. peer support groups, personal planning – advocated in generic self-care policy have value when implemented in a mental health context. Support for self-care in mental health should focus on core, mental health specific qualities; issues of control, enabling staff-service user relationships and shared decision making. The broad empirical basis of our research indicates the wider relevance of our findings across mental health settings

Peer-to-Peer Personal Health Record

Indiana University-Purdue University Indianapolis (IUPUI)Patients and providers need to exchange medical records. Electronic Health Records and Health Information Exchanges leave a patient’s health record fragmented and controlled by the provider. This thesis proposes a Peer-to-Peer Personal Health Record network that can be extended with third-party services. This design enables patient control of health records and the tracing of exchanges. Additionally, as a demonstration of the functionality of a potential third-party, a Hypertension Predictor is developed using MEPS data and deployed as a service in the proposed framework

Theorising interprofessional pedagogic evaluation: framework for evaluating the impact of interprofessional CPD on practice change

This paper outlines the development of a conceptual framework to guide the evaluation of the impact of the pedagogy employed in continuing professional development for professionals in education, health and social care. The work is developed as part of the Centre for Excellence in Teaching and Learning: Interprofessional Learning across the Public Sector (CETL: IPPS) at the University of Southampton. The paper briefly outlines the field for pedagogic research and comments on the underpinning theories that have so far been used to guide research into interprofessional learning (IPL). It maps out the development of interprofessional CPD in its specific context as part of the CETL: IPPS with its links to a local authority undergoing service reorganisation and the role of the continuing professional development (CPD) in effecting change. It then brings together a theoretical framework with the potential toexplore, explain and evaluate the essential features of the model of pedagogy used in interprofessional CPD, in which professionals from education have for the first time been included alongside those from health and social care. The framework draws upon elements of situated learning theory, Activity Theory and Dreier’s work (2002, 1999) on trajectories of participation, particularly Personal Action Potency. By combining the resulting analytic framework with an adapted version of an established evaluation model, a theoretically-driven, practicable evaluation matrix is developed. The matrix has potential use in evaluating the impact of pedagogic input on practice change. The paper models a process for developing a conceptual framework to steer pedagogic evaluation. Such a process and the resulting matrix may be of use to other researchers who are similarly developing pedagogic evaluation

Co-production development of a decision support tool for peers and service users to choose technologies to support recovery

Peer support specialists (i.e., lay interventionists representing one of the fastest-growing mental health workforce) are increasingly using technologies to support individuals with mental health challenges between clinical encounters. The use of technology by peers has been significantly increased During COVID-19. Despite the wide array of technologies available, there is no framework designed specifically for peer support specialists and service users to select technologies to support their personal recovery. The objective of the study was to develop a Decision-Support Tool for Peer Support Specialists and Service Users to facilitate shared decision-making when choosing technologies to support personal recovery. The study used an iterative co-production process, including item formulation and a series of group cognitive interviews with peer support specialists and service users (n=9; n=9, n=4). The total sample included 22 participants: peer support specialists (n=18, 81.8%) and service users (n=4, 18.2%). The final version of the Decision-Support Tool for Peer Support Specialists and Service Users (D-SPSS), includes 8 domains: (1) privacy and security; (2) cost; (3) usability; (4) accessibility; (5) inclusion and equity; (6) recovery principles; (7) personalized for service users’ needs; and (8) device set-up. Our study found that involving peer support specialists and service users in the design and co-production phase of a decision-support tool is feasible and has the potential to empower both peer support specialists and service users, and potentially increase engagement in the use of technologies that support individuals’ recovery from traditional clinical encounters. Experience Framework This article is associated with the Innovation & Technology lens of The Beryl Institute Experience Framework (https://www.theberylinstitute.org/ExperienceFramework). Access other PXJ articles related to this lens. Access other resources related to this len

Setting Research Priorities Within Allied Health: What Do Clinicians Think?

Background: Research activity among allied health clinicians working in publicly funded health care organisations is growing, yet little attention has been paid to how these activities are prioritised. Without a specific framework to guide research direction, it is likely that research will be conducted in areas that are prioritised by individual clinicians. However, it is presently unknown what areas are prioritised by clinicians and the reasoning behind their prioritisation. Purpose: The aims of this study were to identify what clinicians identify to be the highest priority research across personal, department, and health service levels, and the reasons why. It also sought to identify barriers and enablers to conducting this research. Methods: Qualitative, cross-sectional survey with n=95 allied health clinician respondents within one organisation. Survey items relating to research priority were structured across three levels. Survey format consisted of open-ended questions and thematic content analysis was used to categorise responses. Results: The highest priority research across personal, departmental and organisational levels were related to areas of personal work, departmental service and models of care evaluation respectively. The top three priorities in all levels combined were “testing solutions”, “understanding problems or developing solutions” and “implementing evidence-based approaches in real life”. The primary reason provided as to why the research was considered to be of the highest priority was related to the anticipated effectiveness of intervention on patient outcomes and the efficiency of service delivery models being investigated. Time shortages/workload/competing priorities were the most frequently identified barriers to conducting this research, while mentoring /access to university partners/organisational culture/leadership and priorities that favoured research were the most frequently identified enablers. Conclusions: Considerations can be taken from our findings to guide the development of a framework or system to prioritise research projects in the publicly funded health care organisation

Are you satisfied? citizen feedback and delivery of urban services

Citizen feedback is considered an effective means for improving the performance of public utilities. But how well does such information reflect the actual quality of service delivery? Do so-called scorecards or report cards measure public service delivery accurately, or do personal and community characteristics have a significant impact on residents'assessment of service quality? Deichmann and Lall investigate these questions using newly available household survey data on access to and satisfaction with selected public services in two Indian cities-Bangalore and Jaipur. They develop a framework where actual levels of services received, as well as expectations about service performance, influence a household's satisfaction with service delivery. The authors find that satisfaction increases with improvements in the household's own service status, a finding that supports the use of scorecard initiatives. But the results also suggest that a household's satisfaction is influenced by how service quality compares with that of its neighbors or peers and by household level characteristics such as welfare and tenure status. This implies that responses in satisfaction surveys are at least in part determined by factors that are unrelated to the service performance experienced by the household.Health Economics&Finance,Environmental Economics&Policies,Enterprise Development&Reform,Decentralization,Water and Industry,Water Supply and Sanitation Governance and Institutions,Environmental Economics&Policies,Town Water Supply and Sanitation,Governance Indicators,Health Economics&Finance

Examining the Factors Impacting Satisfaction and Loyalty in Innovative Personal Health Assistant Services for Hypertension Patients of a Private Hospital in Thailand

Purpose: The aim of this research is to examine the factors impacting satisfaction and loyalty in innovative personal health assistant services for hypertension patients of a private hospital in Bangkok, Thailand. Research design, data and methodology: Conceptual framework consisted with six variables, reliability, trustworthiness, service quality, hospital image, satisfaction and loyalty, was designed to achieve research objective. Quantitative approach was applied to collect data from 500 respondents. Sampling methods of purposive sampling, stratified random sampling, and convenience sampling were used to scoped to reach target respondents. The reliability of questionnaires has been verified with Item-Objective Congruence (IOC) and pilot test before distribution to target respondents. Data obtained was then analyzed with statistical method of Confirmatory Factor Analysis (CFA) and Structural Equation Modeling (SEM) to test hypothesis proposed for the study. Results: Loyalty of hypertension patients in personal health assistant service was driven by satisfaction, while satisfaction was impacted from service quality, hospital image, and trustworthiness. Service quality played critical role for hypertension patient as it directly impacts satisfaction and hospital image, and indirectly impact loyalty. Conclusions: Marketers, healthcare facilities, and developers of health virtual assistant should focus on delivering service, diagnosis and treatments that meet their needs or beyond their expectation to gain trust, positive hospital image, and satisfaction that also consequently induces commitment in the service