Twelve-year follow-up of conservative management of postnatal urinary and faecal incontinence and prolapse outcomes : randomised controlled trial

© 2013 Royal College of Obstetricians and Gynaecologists. Funded by Royal College of Obstetricians and Gynaecologists, London, UK; Health Research Council of New Zealand. Grant Number: RG 819/06 New Zealand Lottery Grant Board Health Services Research Unit, University of Aberdeen Chief Scientist Office of the Scottish Government Health DirectoratesPeer reviewedPostprin

The interaction between policy and education using stroke as an example

This paper discusses the interaction between healthcare policy at the European, UK and Scottish levels and the funding of education that underpins specific health policy priorities. Stroke is used throughout to illustrate the relationship between a designated European and UK health priority and the translation of that priority into clinical delivery. The necessity to build a responsive and sustainable culture to address the healthcare education that underpins changing healthcare policies is emphasized

Thinking strategically about customers: a view from the health and fitness industry

Customer retention is considered to be one of the key areas for most service providers in the UK Health and Fitness Industry. Much of the existing research and activity concerning customer retention is considered at a tactical, operational level with little emphasis being placed on the strategic considerations that an organisation needs to consider in order to move toward a customer-centred philosophy. This paper suggests that customer retention levels can be improved by thinking more strategically about the organisational purpose, its resources and customers

How was it for you? Experiences of participatory design in the UK health service

Improving co-design methods implies that we need to understand those methods, paying attention to not only the effect of method choices on design outcomes, but also how methods affect the people involved in co-design. In this article, we explore participants' experiences from a year-long participatory health service design project to develop ‘Better Outpatient Services for Older People’. The project followed a defined method called experience-based design (EBD), which represented the state of the art in participatory service design within the UK National Health Service. A sample of participants in the project took part in semi-structured interviews reflecting on their involvement in and their feelings about the project. Our findings suggest that the EBD method that we employed was successful in establishing positive working relationships among the different groups of stakeholders (staff, patients, carers, advocates and design researchers), although conflicts remained throughout the project. Participants' experiences highlighted issues of wider relevance in such participatory design: cost versus benefit, sense of project momentum, locus of control, and assumptions about how change takes place in a complex environment. We propose tactics for dealing with these issues that inform the future development of techniques in user-centred healthcare design

Knowledge management: Using a knowledge requirements framework to enhance UK health sector supply chains

The gaps of mismatch both knowledge and understanding of beneficiaries and solution providers at the initial stage of developing projects have led to the failures of many projects including supply chains (SC) and related information technology systems (ITS) projects (Lyytinen and Hirschheim, 1987) . The aims of this paper are first, to address theoretical framework by bridging the gaps of different types of knowledge. Second, to establishing business requirements and the flow of information in supply chains between beneficiaries and solution providers in the long and complicated supply chains of the UK’s Health Sector. On the basis of brief introduction to knowledge, knowledge management and supply chain, the paper presents a practical framework that has been developed through critical and relevant literatures in the above three subject areas. Techniques and Tools stem from both management science and information systems were used to provide a possible solution for the problem in bridging the gaps of mismatch knowledge and understanding at the initial stage of identifying requirements in projects through knowledge sharing and transfer

The challenges of communicating research evidence in practice: perspectives from UK health visitors and practice nurses

<p>Background: Health practitioners play a pivotal role in providing patients with up-to-date evidence and health information. Evidence-based practice and patient-centred care are transforming the delivery of healthcare in the UK. Health practitioners are increasingly balancing the need to provide evidence-based information against that of facilitating patient choice, which may not always concur with the evidence base. There is limited research exploring how health practitioners working in the UK, and particularly those more autonomous practitioners such as health visitors and practice nurses working in community practice settings, negotiate this challenge. This research provides a descriptive account of how health visitors and practice nurses negotiate the challenges of communicating health information and research evidence in practice.</p> <p>Methods: A total of eighteen in-depth telephone interviews were conducted in the UK between September 2008 and May 2009. The participants comprised nine health visitors and nine practice nurses, recruited via adverts on a nursing website, posters at a practitioner conference and through recommendation. Thematic analysis, with a focus on constant comparative method, was used to analyse the data.</p> <p>Results: The data were grouped into three main themes: communicating evidence to the critically-minded patient; confidence in communicating evidence; and maintaining the integrity of the patient-practitioner relationship. These findings highlight some of the daily challenges that health visitors and practice nurses face with regard to the complex and dynamic nature of evidence and the changing attitudes and expectations of patients. The findings also highlight the tensions that exist between differing philosophies of evidence-based practice and patient-centred care, which can make communicating about evidence a daunting task.</p> <p>Conclusions: If health practitioners are to be effective at communicating research evidence, we suggest that more research and resources need to be focused on contextual factors, such as how research evidence is negotiated, appraised and communicated within the dynamic patient-practitioner relationship.</p&gt

Psychometric analysis of the UK Health and Safety Executive's Management Standards work-related stress Indicator Tool

In the UK the Health & Safety Executive (HSE) Management Standards (MS) work-related stress Indicator Tool is the standard measure that organizations use to assess workplace stress. However, no in-depth analysis has been performed to test the psychometric properties of this scale. The current study is the first to examine the factor structure of the HSE MS Indicator Tool using organizational-level data. Data collected from 39 organizations (N = 26,382) was used to perform a first-order Confirmatory Factor Analysis (CFA) on the original 35-item seven-factor measurement scale. The results showed an acceptable fit to the data for the instrument. A second-order CFA was also performed to test if the Indicator Tool contains a higher order uni-dimensional measure of work-related stress. These findings also revealed an acceptable fit to the data, suggesting that it may be possible to derive a single measure of work-related stress