UK community health visiting: challenges faced during lean implementation

This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole system and together improve service user outcomes

Assessing Homeless Population Size Through the Use of Emergency and Transitional Shelter Services in 1998: Results from the Analysis of Administrative Data from Nine US Jurisdictions

Objectives. This study reports findings from the first-ever systematic enumeration of homeless population size using data previously collected from administrative records of homeless services providers in nine US jurisdictions over a one year period. As such, it provides the basis for establishing an ongoing measure of the parameters of the homeless population and for tracking related trends on the use of homeless services over time. Methods. Each participating jurisdiction collected data through its homeless services management information systems for persons and families who use emergency shelter and transitional housing. The jurisdictions organized the data by a standardized reporting format. These data form the basis for reporting homeless population size, both in raw numbers and as adjusted for each jurisdiction’s overall population size, as well as the rate of turnover and average annual length of stay in emergency shelters and transitional housing. Results. Individual jurisdictions had annual rates of sheltered homelessness ranging from 0.1% to 2.1% of their overall population, and 1.3% to 10.2% of their poverty population. Annual population size was 2.5 to 10.2 times greater than the point-prevalent population size. Results are broken down for adults and families. Conclusions. The prevalence of homelessness varies greatly among the jurisdictions included in this study, and possible factors for this diversity are discussed. Future reports of this nature will furnish similar series of homeless enumerations across a growing number of jurisdictions, thereby providing a basis for exploring the effects of different contextual factors on local prevalence rates of homelessness

Teaching Interprofessional Core Competencies Through An International Service Learning Experience

AOTA Poster Proposal: 2014 Susan M. Cleghorn Title of Proposed Session: Teaching Interprofessional Education (IPE) Core Competencies Through An International Service Learning Experience Poster Intermediate level was chosen because the presentation takes two known teaching concepts, IPE & service learning, and expands the use through developing core competencies in an international experience rich in cultural considerations. Primary Focus Academic & Fieldwork Education International & Cultural Issues Speaker Qualifications: Susan M. Cleghorn, MS, OTRL, TRS has 20+ yearlps of experience as a Recreation Therapist and 10+ years as an Occupational Therapist and just completed her Certified Aging in Place (CAPS) Training. Clinical practice includes community based and clinical settings including: skilled nursing homes, home health care, mental health, and schools with pediatric and older adult populations. Susan is beginning her 6th year teaching in the MSOT program at Grand Valley State University where she teaches courses across the life span including school based OT, conditions, group interventions, and older adult practice. Susan also serves as the Service Learning Coordinator. Susan has developed 8-10 annual domestic service learning opportunities for graduate students and 1 annual international experience. Susan has presented at AOTA, student symposiums, intermediate school districts, and local builders associations. She has been published in the International Journal of Bereavement Care and is pursuing an OTD at Creighton University with research interests in Community-Based Services for Children with Autism and Community Health Promotion using OT and Aging in Place. Denise P. Meier, MA, OTRL has been a part-time clinical professor at Grand Valley State University in the Occupational Therapy Department for the past 17 years. Denise developed the pediatric curriculum which she currently team-teaches. Courses developed include: Pediatric content, laboratory, OT Theory, OT Foundations. Denises clinical practice focuses on Community-Based Treatment with the birth to three population, specifically in Early Intervention, with expertise in feeding and sensory integration. She earned her Masters degree in Occupational Therapy from Tufts University. Her research interests include : Use of Sensory Integration in the Home Environment, Evaluation of Community Play Space for Children with Disabilities, and the Use of the Coaching Model for OT Interventions in the Home Environment. At the conclusion of this presentation, the learner will be able to: 1. Identify the unique benefits of an International IPE service learning experience for graduate students. 2. Identify IPE core competencies and how to structure a service learning opportunity so that students may apply these competencies with clients that have diverse needs. Abstract Occupational therapy educators are challenged to provide learning opportunities that facilitate collaboration, critical thinking, and clinical reasoning skills in the context of real-world settings. The World Health Organization (2010) identifies interprofessional education (IPE) as a key method for preparing healthcare professionals in the 21st century stating, It is no longer enough for health workers to be professional. In the current global climate, health workers also need to be interprofessional (p.36). The goal of IPE is to facilitate collaboration among students in order to increase understanding of professional roles, improve communication, and enable coordinated teamwork. While there are many venues for IPE, including laboratories, patient simulations, and case-based learning, service learning provides students with real world experiences in context. In addition, international service learning provides students with the cultural component necessary for successful patient care in todays global market. Rosenberg (2000) defines service learning as, more than volunteerism, service-learning combines community work with classroom instruction, emphasizing reflection as well as action. It empowers students by making them responsible in a real world context, while giving them the support, encouragement, information, and skills to be effective (p.8). The purpose of this presentation is to describe how an occupational and physical therapy program partnered to develop an international interprofessional service learning experience for graduate students. The goal of this educational partnership was for students to develop IPE core competencies including, values/ethics for interprofessional practice, roles/responsibilities, interprofessional communication, and teamwork. References Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative. Rosenberg,L. Becoming the Change We Wish to See in the World: Combating Through Service Learning Learned Passivity. Academic Exchange Quarterly, 2000, 4, 6-11. World Health Organization (WHO). (2010). Framework for action on interprofessional education & collaborative practice. Geneva: World Health Organization. Retrieved April 11, 2011 from http://whqlibdoc.who.int/ hq/2010/WHO_HRH_HPN_10.3_eng.pdf Abstract Synopsis The purpose of this presentation is to guide OT educators understanding of how to use an Interprofessional Education (IPE) teaching method within an International Service Learning context to develop student competencies in ethics, roles, communication, and teamwork