The role of boundary spanners in delivering collaborative care: a process evaluation

BACKGROUND: On average, people with schizophrenia and psychosis die 13–30 years sooner than the general population (World Psychiatry 10 (1):52–77, 2011). Mental and physical health care is often provided by different organisations, different practitioners and in different settings which makes collaborative care difficult. Research is needed to understand and map the impact of new collaborative ways of working at the primary/secondary care interface (PloS One 7 (5); e36468). The evaluation presented in this paper was designed to explore the potential of a Community and Physical Health Co-ordinator role (CPHC) (CPHCs were previously Care Co-ordinators within the Community Mental Health Team, Community in the title CPHC refers to Community Mental Health) and Multi-Disciplinary Team (MDT) meetings across primary and community care, with the aim of improving collaboration of mental and physical health care for service users with Severe Mental Illness (SMI). METHODS: Data collection took place across five general practices (GPs) and a Community Mental Health Team (CMHT) in the Northwest of England, as part of a process evaluation. Semi-structured interviews were conducted with a purposive sample of GP staff (n= 18) and CMHT staff (n=4), a focus group with CMHT staff (n=8) and a survey completed by 13 CMHT staff, alongside cardiovascular risk data and MDT actions. Framework analysis was used to manage and interpret data. RESULTS: The results from the evaluation demonstrate that a CPHC role and MDT meetings are effective mechanisms for improving the collaboration and co-ordination of physical health care for SMI service users. The findings highlight the importance of embedding and supporting the CPHC role, with an emphasis on protected time and continuing professional roles and integrating multiple perspectives through MDT meetings. Considering the importance of physical health care for SMI service users and the complex environment, these are important findings for practitioners, researchers and policy makers in the field of primary care and mental health. CONCLUSION: There is an increasing focus on integration and collaborative working to ensure the delivery of quality care across the whole patient pathway, with a growing need for professionals to work together across service and professional boundaries. The introduction of a two pronged approach to collaboration has shown some important improvements in the management of physical health care for service users with SMI

The potential of online coaching to develop female entrepreneurial self-efficacy

Purpose – The purpose of this study is to explore the potential of coaching to develop female entrepreneurship by overcoming potential barriers. It sought to understand how entrepreneurial self-efficacy can be applied to development relationships, through on-line coaching, examining changes in the four key elements of entrepreneurial self-efficacy enactive mastery, vicarious experiences, social persuasion and psychological arousal. The study examines the impact of coaching relationships on female entrepreneurial self-efficacy compared to a control group. The participant group was matched with coaches and undertook a structured six months’ coaching programme. Design/methodology/approach – This was a longitudinal study using a mixed methods approach. Questionnaires investigating entrepreneurial self-efficacy were collected at two time points for both the coaching and control group. After the first time point, the coaching group was supported through a six months coaching development programme. At the second time point, questionnaires were again completed by both groups and qualitative data gather via interviews with the coaching group. Findings – The findings from this study showed that coaching relationships had a positive impact on coachees’ entrepreneurial self-efficacy, compared to the control group in terms of enactive mastery, vicarious experience, social persuasion and psychological arousal. This suggests that coaching is a development intervention which can be used to enhance self-efficacy beliefs of female entrepreneurs, thereby increasing their chances of engaging in successful business creation and operation. Research limitations/implications – The group size was a problem, with four of the coaching group and ten of the control group dropping out. The coaching participants left the intervention due to personal reasons but no reason could be established for the control group participants leaving the study. The problem of ‘Type II’ was considered and in an attempt to overcome this problem, data were shown at below 10% (p <0.10). It would also have been useful to collect more qualitative data from the control group. Practical implications – An online coaching programme provided by women for women, which is tailored to the individual, can support female entrepreneurs through the difficult stages of start-up and development phases of business development. Creating more successful women owned businesses will not only provide financial benefits, but should help provide additional entrepreneurial networks for women, as well as more positive female role models. Exposure to positive role models has been found to have a direct effect on entrepreneurial self-efficacy. This circular affect should in theory keep on increasing, if female entrepreneurs have access to the tailored support provided by coaching programmes such as the one used here. Social implications – Considering the current global economic climate, it is increasingly important for women to be supported in small business ownership (Denis, 2012). Countries which actively promote women entering into business ownership will ultimately share the gains in terms of wider issues, i.e. improving education and health, and economic growth (Harding, 2007). If female entrepreneurship is to be encouraged and supported, provision needs to be designed and developed based on female entrepreneurs’ needs and requirements, rather than simply conforming to traditional business support models. Originality/value – This study contributes to learning and theoretical debates by providing an understanding of female entrepreneurs’ needs with regard to business support and how this can be related to and supported by coaching. It also adds to the literature on entrepreneurial self-efficacy, coaching and learning by providing empirical evidence to illustrate how coaching interventions, including the use of online methods, can have a positive impact on female entrepreneurial self-efficacy

Online coaching: An alternative source of social support for female entrepreneurs during venture creation

This article explores women’s experiences of accessing social support from traditional sources during venture creation and identifies the key aspects of social support desired, required and sought. It explores how an online coaching programme could provide the specific types of social support that would be most effective in assisting female entrepreneurs during venture creation. A study is presented based upon interviews with 30 established and 30 potential female entrepreneurs. The findings suggest that an online relationship with a dedicated coach of the same gender could provide the required support in terms of quantity and quality in respect of all functional aspects of social support. </jats:p