Exploring changes in patient experience with increasing practice size: observational study using data from the General Practice Patient Survey

Background For the last few years, English general practices, which are traditionally small, have been encouraged to work together to serve larger populations of registered patients, by merging or collaborating with each other. Meanwhile, patient surveys suggest worsening continuity of care and access to care. Aim To explore whether increasing size of practice population and working collaboratively are linked to changes in continuity of care or access to care. Design and setting Observational study in English general practice using data on patient experience, practice size and collaborative working Methods The main outcome measures were General Practice Patient Survey practice-level proportions of patients reporting positive experiences of access and relationship continuity of care. We compared change in proportions 2013-2018 among practices that had grown and those that had stayed about the same size. We also compared patients’ experiences by whether practices were working in close collaborations or not in 2018. Results. Practices that had grown in population size had a greater percentage fall in continuity of care, by 6.6% (95% confidence interval 4.3% to 8.9%) than practices that had stayed about the same size, after controlling for other factors. There was no similar difference in relation to access to care. Practices collaborating closely with others had marginally worse continuity of care than those not working in collaboration and no important differences in access. Conclusion Concerns that larger general practice size threatens continuity of care may be justified

A Social Network Study To Improve Collaborative Partnerships Among the Southeastern Health Equity Council (SHEC)

This report presents research conducted on the relationships among and attributes of members of the Southeastern Health Equity Council (SHEC, herein Council) to provide recommendations for partnerships, collaboration, and the recruitment of new members. The background, methods, results, and recommendations are outlined in detail throughout this report. Social networks are measured and defined as connections among people, organization, and/or other units. SNA is a valuable and innovative tool for recognizing strengths and weaknesses in collaborative partnerships. The evaluative study presented herein can be replicated in other councils within the Regional Health Equity Councils to improve collaborations not only among SHEC partnerships, but also the nine remaining regions as well. Among the SHEC, social networking models will be designed in an efforts to better understand partnerships, reach the desire goal to analyze partnerships among SHEC, and develop a better understanding of the broad-based constituency served by the Council for the purposes of improving collaborative partnerships

Crowdsourcing in Product Development: Current State and Future Research Directions

The term crowdsourcing has been identified as a valuable paradigm in the open design movement. Despite its proven value, research focusing specifically on crowdsourcing in product development has been stagnating, with the general tone in this sector having moved from optimism to skepticism. In this paper, the authors present a literature analysis that reveals four hurdles limiting industry adoption. The authors are then able to suggest future research avenues that they anticipate will encourage adoption of crowdsourcing in professional product design and development settings in industry

Research on Teaching about Earth in the Context of Societal Problems

Knowledge and consideration of societal issues are critical for students majoring in the geosciences, as well as for non-science students and the general public who vote and make decisions that should be based on sound science. Thus, the importance of integrating geoscience with other disciplines such as urban planning, social justice, politics, communications and more has become a critical call to action for geoscience researchers and educators that merits examination. Improving undergraduate STEM education with the use of relevant issues such as societal problems is a useful mechanism to help students find science to be personally relevant and to develop their interest based on societal contexts (e.g., as is currently being done in the InTeGrate program). The grand challenges in this chapter examine the use of societal issues to teach about the Earth, which include consideration of the impact on student learning, the design principles of curricula that best integrate geoscience content within the context of societal issues, and the assessment needed to measure the efficacy of these methods

Amplifying Quiet Voices: Challenges and Opportunities for Participatory Design at an Urban Scale

Many Smart City projects are beginning to consider the role of citizens. However, current methods for engaging urban populations in participatory design activities are somewhat limited. In this paper, we describe an approach taken to empower socially disadvantaged citizens, using a variety of both social and technological tools, in a smart city project. Through analysing the nature of citizens’ concerns and proposed solutions, we explore the benefits of our approach, arguing that engaging citizens can uncover hyper-local concerns that provide a foundation for finding solutions to address citizen concerns. By reflecting on our approach, we identify four key challenges to utilising participatory design at an urban scale; balancing scale with the personal, who has control of the process, who is participating and integrating citizen-led work with local authorities. By addressing these challenges, we will be able to truly engage citizens as collaborators in co-designing their city

How Widespread Is Working at Scale in English General Practice? an Observational Study

Background Over the last five years, national policy has encouraged practices to serve populations of >30,000 people (called 'working at scale'), by collaborating with other practices. Aim To describe the number of English general practices working at scale, and their patient populations. Design and setting Observational study of general practice in England Methods We supplemented data published by the National Health Service on practices' self-reports of working in groups with data from reports by various organisations and websites of practice groups. We categorised practices by the extent to which they were working at scale, and examined age distribution of practice population, level of socioeconomic deprivation, rurality and prevalence of longstanding illness by these categories. Results About 55% English practices (serving 33 million patients) were working at scale, individually or collectively serving populations of >30,000 people. Organisations models representing close collaboration for the purposes of core general practice services were identifiable for ~5% of practices; these were: large practices; superpartnerships, and multisite organisations. About 50% of practices were working in looser forms of collaboration focusing on services beyond core general practice, e.g. primary care in the evenings and weekends. Data on organisations models and purpose of the collaboration were very limited for this group. Conclusions In early 2018, <5% of general practices were working closely at scale; about half of practices were working more loosely at scale. Data were, however, incomplete. Understanding what is happening at practice level is needed so that we can evaluate benefits and harms