Journal of Health Services Research and Policy via MedWorm.com MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Health Services Research and Policy' source. Thu, 09 Feb 2012 10:12:58 +0100 Myth: C-sections are on the rise because more mothers are asking for them http://www.medworm.com/index.php?rid=5654869&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F63%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654869 Wed, 25 Jan 2012 05:00:00 +0100 5654869 The teacher and the cop: the role of 'private space' in increasingly transparent clinical practice http://www.medworm.com/index.php?rid=5654868&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F60%3Frss%3D1 Education and enforcement have been two contrasting ways of managing clinical performance. Both are needed but recently health policy has placed greater emphasis on the latter, possibly to the detriment of the former. This paper examines the ways in which education and other formative aspects of clinical practice can be conducted. The boundary between education and enforcement involves a distinction between public and private space. Private space is the territory within which clinicians can review their performance and improve it from an educational perspective. The boundary between public and private space is fluid, particularly since the advent of systems to ensure clinicians' competence. The sensitive management of this boundary will determine whether the benefits of transparent clinica... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654868 Wed, 25 Jan 2012 05:00:00 +0100 5654868 Assuring the safety and effectiveness of new drugs: rigorous phase IV trials randomizing general practices to delayed access to new drugs http://www.medworm.com/index.php?rid=5654867&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F56%3Frss%3D1 Randomized trials are crucial for establishing the effectiveness of new drugs and procedures. However, they are less effective at detecting uncommon but clinically significant side effects. We propose a solution. All UK general practices could be randomized to be allowed to prescribe new licenced drugs earlier or later. This would produce a large pragmatic cluster trial which could enable rare, but harmful, effects to be demonstrated more quickly than the current usual practice of looking for harmful events in observational datasets. Given current computerization of practice records such an approach is feasible and likely to be cost-effective. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654867 Wed, 25 Jan 2012 05:00:00 +0100 5654867 Technology in context http://www.medworm.com/index.php?rid=5654866&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F53%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654866 Wed, 25 Jan 2012 05:00:00 +0100 5654866 Evidence for the credibility of health economic models for health policy decision-making: a systematic literature review of screening for abdominal aortic aneurysms http://www.medworm.com/index.php?rid=5654865&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F44%3Frss%3D1 Conclusions Researchers in the field seem to have benefited from general advances in health economic modelling and some improvements in reporting were noted. However, the low level of agreement between studies in model structures and assumptions, and difficulty in justifying these (convergent validity), remain a threat to the credibility of health economic models. Decision-makers should not accept the results of a modelling study if the methods are not fully transparent and justified. Modellers should, whenever relevant, supplement a primary report of results with a technical report detailing and discussing the methodological choices made. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654865 Wed, 25 Jan 2012 05:00:00 +0100 5654865 Failure Mode and Effects Analysis: views of hospital staff in the UK http://www.medworm.com/index.php?rid=5654864&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F37%3Frss%3D1 Conclusion FMEA is a subjective but systematic tool that helps identify high risk areas, but its time consuming nature, difficulty with the scores and perceived lack of validity and reliability may limit its widespread use. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654864 Wed, 25 Jan 2012 05:00:00 +0100 5654864 Assessing the effects of removing user fees in Zambia and Niger http://www.medworm.com/index.php?rid=5654863&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F30%3Frss%3D1 Conclusion These results highlight the importance of paying attention to implementation challenges and monitoring the effects of policy reforms which are often more mixed and complicated that they appear. The comparison of these reforms in two countries also sheds light on the potentially different ways in which free care can be used as a tool to improve access. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654863 Wed, 25 Jan 2012 05:00:00 +0100 5654863 Effectiveness and acceptability of delivery of antiretroviral treatment in health centres by health officers and nurses in Ethiopia http://www.medworm.com/index.php?rid=5654862&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F24%3Frss%3D1 Conclusion ART delivery in health centres, based on health officers and nurses is feasible, effective and acceptable in Ethiopia. However, issues related to regulation, remuneration and cost need to be addressed for the sustainable implementation of these delivery models. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654862 Wed, 25 Jan 2012 05:00:00 +0100 5654862 Geographic variation in the cost of ambulatory care in Switzerland http://www.medworm.com/index.php?rid=5654861&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F18%3Frss%3D1 Conclusions There are persistent regional differences in the per capita cost of ambulatory care that are not explained by demographic factors, access to care, or needs. It is likely that higher access to care leads to greater inappropriate use, particularly of specialists. Implementing gatekeeping systems and financial incentives that encourage better coordination of primary care may slow growth in costs and improve care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654861 Wed, 25 Jan 2012 05:00:00 +0100 5654861 'Animateurs' and animation: what makes a good commissioning manager? http://www.medworm.com/index.php?rid=5654860&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F11%3Frss%3D1 Conclusions From 2012/13 it is planned that GPs will be taking more responsibility for commissioning in the English NHS. This research suggests that managers of the new commissioning organizations will require a deep and contextualized understanding of the NHS and that it is important that organizational processes do not inhibit managerial behaviour. Legitimacy may be an issue in contexts were managers are automatically transferred from their existing appointments. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654860 Wed, 25 Jan 2012 05:00:00 +0100 5654860 Climate for evidence-informed health systems: a profile of systematic review production in 41 low- and middle-income countries, 1996-2008 http://www.medworm.com/index.php?rid=5654859&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F4%3Frss%3D1 Conclusion In many countries, those seeking to support evidence-informed health systems cannot turn to experienced local systematic reviewers to help them to find and use systematic reviews or to conduct reviews on high priority topics when none exists. These findings suggest the need for local capacity-building initiatives. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654859 Wed, 25 Jan 2012 05:00:00 +0100 5654859 Audit of submissions: July 2010-June 2011 http://www.medworm.com/index.php?rid=5654858&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F3%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654858 Wed, 25 Jan 2012 05:00:00 +0100 5654858 Driving up the quality and relevance of research through the use of agreed core outcomes http://www.medworm.com/index.php?rid=5654857&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F17%2F1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5654857 Wed, 25 Jan 2012 05:00:00 +0100 5654857 Images of health care http://www.medworm.com/index.php?rid=5280171&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F254%3Frss%3D1 ‘A picture is worth a thousand words’ captures the idea that well chosen images can increase the successful dissemination of health care messages. This edition of ‘What's on the web’ explores sites that host images suitable for use in presentations and teaching. We have focused on sites that provide images that are in the public domain or have a creative commons license which generally allows non-commercial use. It is important to be careful, however, and it is recommended that you check the copyright situation before using any image from these sites. If you have any comments on this column, please contact: Kate Light Information Specialist Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kate.light@york.ac.uk) (Source: Journal of He... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280171 Fri, 30 Sep 2011 04:00:00 +0100 5280171 Myth: The ageing population is to blame for uncontrollable health care costs http://www.medworm.com/index.php?rid=5280170&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F252%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280170 Fri, 30 Sep 2011 04:00:00 +0100 5280170 Moving (realistically) from volume-based to value-based health care payment in the USA: starting with Medicare payment policy http://www.medworm.com/index.php?rid=5280169&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F249%3Frss%3D1 Employers and policy-makers in the USA are desperate to slow the rate at which health expenditures grow. Changing how most health care providers are reimbursed will be necessary to achieve this. Although both politically and practically daunting, massive restructuring or replacement of fee-for-service (FFS) reimbursement is what is most required. As the dominant reimbursement model in the USA, FFS payment to individual providers strongly encourages and financially rewards the quantity of care provided, regardless of its quality or necessity. Providing high quality, lower cost care with fewer complications and hospital re-admissions can even financial penalize providers. Unfortunately, physicians and other health providers respond rationally to existing financial incentives (translation: th... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280169 Fri, 30 Sep 2011 04:00:00 +0100 5280169 Greening health care: how hard can that be? http://www.medworm.com/index.php?rid=5280168&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F247%3Frss%3D1 There are two key policy questions when addressing climate change and health care: where do we start and how do we move forward? This pragmatic exploration of the climate change issue and its impact on health care delivery starts from the premise that a proper understanding of the scope of the problem and a focus for bringing a broad range of people together to develop solutions is the place to begin policy discussions. Far from a standing start, there is much work already underway at the global and local levels. What is recommended is a forum that can bring people and ideas together in a creative, engaged and cross-generational dialogue that prepares for change in health care to meet the challenge of climate change. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280168 Fri, 30 Sep 2011 04:00:00 +0100 5280168 A trifle of management http://www.medworm.com/index.php?rid=5280167&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F245%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280167 Fri, 30 Sep 2011 04:00:00 +0100 5280167 How do we know when research from one setting can be useful in another? A review of external validity, applicability and transferability frameworks http://www.medworm.com/index.php?rid=5280166&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F238%3Frss%3D1 Conclusion A validated framework of applicability and transferability would help those aiming to encourage research use, as well as those conducting research. Greater understanding of applicability and transferability could help to encourage the appropriate use of research and the development of research that is more useful. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280166 Fri, 30 Sep 2011 04:00:00 +0100 5280166 Are NHS foundation trusts able and willing to exercise autonomy? 'You can take a horse to water...' http://www.medworm.com/index.php?rid=5280165&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F232%3Frss%3D1 This article examines the implementation of FTs in the NHS and focuses on the nature and exercise of autonomy by FTs. It argues that the ability of FTs to exercise autonomy is in place, but the (relatively limited) extent of implementation may be explained by trusts' lack of willingness to exercise such autonomy. Such unwillingness may be because of continued centralization, unclear policy and financial regimes, fear of negative impacts on relations with other local organizations, and awareness of greater risk to the FT, among others. Addressing the tension between FTs' ability and willingness to exercise autonomy will largely explain the extent to which the government's provider side reforms will be implemented. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280165 Fri, 30 Sep 2011 04:00:00 +0100 5280165 We can't afford my chronic illness! The out-of-pocket burden associated with managing chronic obstructive pulmonary disease in western Sydney, Australia http://www.medworm.com/index.php?rid=5280164&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F226%3Frss%3D1 Conclusions The costs associated with living with COPD make it difficult for patients and their families to afford necessary living expenses while also paying health care expenses. This is alarming within Australia where a well-funded universal health insurance system is in place. Rising co-payments for medications and private medical consultations, poorly subsidised health support (e.g. home oxygen), non-health logistics (e.g. transport) and eligibility barriers for existing social support are making chronic illness management seriously economically stressful, especially for those with low incomes, including the retired. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280164 Fri, 30 Sep 2011 04:00:00 +0100 5280164 Making the most of evaluation: a mixed methods study in the English NHS http://www.medworm.com/index.php?rid=5280163&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F218%3Frss%3D1 Conclusions Considerable public resources are committed to evaluation, but this investment is less productive than it could be. This article specifies several ways in which the use of evaluation of initiatives in health and social care could be improved. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280163 Fri, 30 Sep 2011 04:00:00 +0100 5280163 Prospects for knowledge exchange in health policy and management: institutional and epistemic boundaries http://www.medworm.com/index.php?rid=5280162&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F211%3Frss%3D1 Conclusions Efforts to promote greater interaction between research, policy and practice, and more critical, reflexive engagement between policy-makers, managers and researchers, are likely to face significant obstacles given these competing constructions of research knowledge and their reinforcement by divergent priorities. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280162 Fri, 30 Sep 2011 04:00:00 +0100 5280162 Do market fees differ from relative value scale fees? Examining surgeon payments in New Zealand http://www.medworm.com/index.php?rid=5280161&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F203%3Frss%3D1 Conclusions Surgical fees were generally consistent with those predicted by the RBRVS. However, the fees for high volume procedures were relatively lower than predicted while the fees for low volume procedures appeared more variable. The findings are consistent with the hypothesis that market forces lowered prices for procedures with higher volumes. This has implications for how health funders might determine private surgical fees, especially in mixed public-private systems. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280161 Fri, 30 Sep 2011 04:00:00 +0100 5280161 Impact of socioeconomic factors on in-patient length of stay and their consequences in per case hospital payment systems http://www.medworm.com/index.php?rid=5280160&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F197%3Frss%3D1 Conclusion SE factors are a predictor of in-patient LOS and should be taken into account in per case resource allocation among hospitals. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280160 Fri, 30 Sep 2011 04:00:00 +0100 5280160 'Bending the cost curve' and the politics of cost control http://www.medworm.com/index.php?rid=5280159&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F195%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280159 Fri, 30 Sep 2011 04:00:00 +0100 5280159 Making competition work in the English NHS: the case for maintaining regulated prices http://www.medworm.com/index.php?rid=5280158&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F4%2F193%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280158 Fri, 30 Sep 2011 04:00:00 +0100 5280158 Health services research in Europe and its use for informing policy http://www.medworm.com/index.php?rid=5280177&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F48%3Frss%3D1 Conclusion HSR is unevenly developed across Europe. There is considerable scope to build the infrastructure and to take steps to improve the use of HSR in policy-making. There is also a need for research, as opposed to expert opinion, on how HSR is undertaken and used. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280177 Thu, 07 Jul 2011 04:00:00 +0100 5280177 Health services research related to performance indicators and benchmarking in Europe http://www.medworm.com/index.php?rid=5280176&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F38%3Frss%3D1 Conclusions This study suggests a number of themes for future research. These include testing and improving: the validity and reliability of performance indicators, especially related to avoidable mortality and other outcome indicators; the effectiveness and efficiency of embedding performance indicators in the various governance, monitoring and management models, and their effect on health systems, services and professionals; and the effectiveness and efficiency of linking performance indicators to other national and international strategies and policies such as accreditation and certification, practice guidelines, audits, quality systems, patient safety strategies, national standards on volume and/or quality, public reporting, pay-for-performance and patient/consumer involvement. The fie... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280176 Thu, 07 Jul 2011 04:00:00 +0100 5280176 Mapping research on health systems in Europe: a bibliometric assessment http://www.medworm.com/index.php?rid=5280175&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F27%3Frss%3D1 Conclusion There is a wide-spread need to develop health systems research capacity, in particular in eastern European countries, and to address the effects of health care reform, particularly the effects of privatization and commercialization of health services. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280175 Thu, 07 Jul 2011 04:00:00 +0100 5280175 European priorities for research on health care organizations and service delivery http://www.medworm.com/index.php?rid=5280174&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F16%3Frss%3D1 Conclusions The research priorities identified in this study relate to important shared challenges in Europe's health care systems. This makes cross-border learning important, especially given the clear geographical variation in health services research (HSR) funding and capacity in Europe. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280174 Thu, 07 Jul 2011 04:00:00 +0100 5280174 Health technology assessment: research trends and future priorities in Europe http://www.medworm.com/index.php?rid=5280173&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F6%3Frss%3D1 Conclusions The research priorities identified are important for obtaining high quality and cost-effective health care in Europe. Managing the introduction, use and phasing out of technologies challenges health services throughout Europe, and these processes need to be improved to successfully manage future more general challenges. An ageing population and a diminishing workforce both require strong efforts to ensure effective and well-organized use of human resources and technologies. Furthermore, Europe needs to focus on innovation. This is closely linked to use of technologies and calls for future research. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280173 Thu, 07 Jul 2011 04:00:00 +0100 5280173 Health services research in Europe: evaluating and improving its contribution to health care policy http://www.medworm.com/index.php?rid=5280172&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_2%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=5280172 Thu, 07 Jul 2011 04:00:00 +0100 5280172 Sustainable health care http://www.medworm.com/index.php?rid=4990445&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F190%3Frss%3D1 Issues concerning our impact on the environment are constantly in the news and people are becoming more aware of the contribution of health care to the situation. This edition of ‘What's on the web’ reviews sites that provide information about the ways health care facilities can mitigate their effects on the environment. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kate Light Information Specialist Centre for Reviews and Dissemination University of York, York YO10 5DD, UK (Email: kate.light@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990445 Wed, 29 Jun 2011 23:00:00 +0100 4990445 The political abuse of international health system comparisons http://www.medworm.com/index.php?rid=4990444&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F187%3Frss%3D1 Though the science of medicine subscribes to learning from best practices and the transmission of superior treatment regimens across national boundaries, the same ethos does not inform political debates surrounding health system reform. The Canadian and English health systems have been used – and, more frequently – abused by American politicians in their quest to support their own model of reform, or preserve the status quo. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990444 Wed, 29 Jun 2011 23:00:00 +0100 4990444 Shaping strategic change: making change in large organizations http://www.medworm.com/index.php?rid=4990443&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F184%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990443 Wed, 29 Jun 2011 23:00:00 +0100 4990443 Evaluating 'success' in programme budgeting and marginal analysis: a literature review http://www.medworm.com/index.php?rid=4990442&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F177%3Frss%3D1 Conclusions The rate of success is clearly influenced by how success is defined. There is a need for a broadly accepted definition of success to be used when evaluating PBMA applications so to enable direct comparisons of studies. This evaluatory component needs to be adjacent to PBMA and not a separate procedure. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990442 Wed, 29 Jun 2011 23:00:00 +0100 4990442 Understanding phenomena in the real world: the case for real time data collection in health services research http://www.medworm.com/index.php?rid=4990441&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F172%3Frss%3D1 Understanding the environmental and behavioural predictors of wellbeing is a key driver of health and social care research. Research set in the social world examines the relationships between behavioural, cognitive, emotional and environmental factors, linking these to disease or social ills with the aim of providing better preventive or treatment services. Much of this research is based on retrospective measurement tools, such as questionnaires or interviews. However, retrospective accounts are prone to bias arising from the influence of the participant's current affective state on autobiographical memory and error-inducing heuristic strategies related to memory. Participant introspection also biases self-reports of behaviour and symptoms. This essay offers a critical examination of the a... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990441 Wed, 29 Jun 2011 23:00:00 +0100 4990441 Statistical synthesis of contextual knowledge to increase the effectiveness of theory-based behaviour change interventions http://www.medworm.com/index.php?rid=4990440&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F167%3Frss%3D1 Tailored implementation strategies targeting health professionals' adoption of evidence-based recommendations are currently being developed. Research has focused on how to select an appropriate theoretical base, how to use that theoretical base to explore the local context, and how to translate theoretical constructs associated with the key factors found to influence innovation adoption into feasible and tailored implementation strategies. The reasons why an intervention is thought not to have worked are often cited as being: inappropriate choice of theoretical base; unsystematic development of the implementation strategies; and a poor evidence base to guide the process. One area of implementation research that is commonly overlooked is how to synthesize the data collected in a local conte... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990440 Wed, 29 Jun 2011 23:00:00 +0100 4990440 Health services use associated with emergency department closure http://www.medworm.com/index.php?rid=4990439&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F161%3Frss%3D1 Conclusions Emergency services at neighbouring hospitals (40 kilometres distance) were able to compensate, in part, for the decreased local emergency service provision. Concurrent changes in health care utilization patterns were observed among local residents that varied by gender. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990439 Wed, 29 Jun 2011 23:00:00 +0100 4990439 The use of external consultants by NHS commissioners in England: what lessons can be drawn for GP commissioning? http://www.medworm.com/index.php?rid=4990438&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F153%3Frss%3D1 Conclusions External support can play a role in improving the quality of commissioning. However, certain pitfalls must be avoided if it is to be used effectively. The role of external support will evolve (and may expand) as commissioning responsibilities are transferred to general practice consortia. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990438 Wed, 29 Jun 2011 23:00:00 +0100 4990438 Assessing the suitability of fractional polynomial methods in health services research: a perspective on the categorization epidemic http://www.medworm.com/index.php?rid=4990437&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F147%3Frss%3D1 Conclusions Although it is common practice, categorization comes at a cost. Information is lost, and accuracy and statistical power reduced, leading to spurious statistical interpretation of the data. The fractional polynomial method is widely supported by statistical software programs, and deserves greater attention and use. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990437 Wed, 29 Jun 2011 23:00:00 +0100 4990437 Marginal costs of hospital-acquired conditions: information for priority-setting for patient safety programmes and research http://www.medworm.com/index.php?rid=4990436&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F141%3Frss%3D1 Conclusions Patient safety efforts frequently focus on dramatic but rare complications with very serious patient harm. Previous studies of the costs of adverse events have provided information on ‘indicators’ of safety problems rather than the full range of hospital-acquired conditions. Adding a cost dimension to priority-setting could result in changes to the focus of patient safety programmes and research. Financial information should be combined with information on patient outcomes to allow for cost-utility evaluation of future interventions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990436 Wed, 29 Jun 2011 23:00:00 +0100 4990436 Emergency respiratory admissions: influence of practice, population and hospital factors http://www.medworm.com/index.php?rid=4990435&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F133%3Frss%3D1 Conclusions Practice population, geographic and hospital supply factors are consistently associated with asthma and COPD admissions. Higher smoking rates among such patients in a practice are associated with higher admission rates. There is little evidence from this study that other modifiable general practice factors are important in influencing admission rates. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990435 Wed, 29 Jun 2011 23:00:00 +0100 4990435 Does quality improvement face a legitimacy crisis? Poor quality studies, small effects http://www.medworm.com/index.php?rid=4990434&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F131%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990434 Wed, 29 Jun 2011 23:00:00 +0100 4990434 Raising the profile of simulation and modelling in health services planning and implementation http://www.medworm.com/index.php?rid=4990433&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F3%2F129%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990433 Wed, 29 Jun 2011 23:00:00 +0100 4990433 A quest for patient-safe culture: contextual influences on patient safety performance http://www.medworm.com/index.php?rid=4990455&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F57%3Frss%3D1 Conclusion The study highlights the massive and unpredictable impact of both internal and external environmental shocks and how they destabilize trusts distracting attention from patient safety. It also underlines the importance of regular self-assessment of internal and external risks and awareness of context. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990455 Thu, 31 Mar 2011 23:00:00 +0100 4990455 Challenges and opportunities associated with the introduction of assistant practitioners supporting the work of registered nurses in NHS acute hospital trusts in England http://www.medworm.com/index.php?rid=4990454&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F50%3Frss%3D1 Conclusions Findings from this study will help policy-makers, organizations and practitioners understand factors that enable and/or inhibit the integration of new assistant roles within existing occupational structures to develop innovative services and enhance patient care. These factors are important when considering how care will be delivered to maximize the skills of the entire nursing workforce. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990454 Thu, 31 Mar 2011 23:00:00 +0100 4990454 Organizing and delivering diabetes education and self-care support: findings of scoping project http://www.medworm.com/index.php?rid=4990453&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F42%3Frss%3D1 Conclusion The clinical benefit of the identified models need to be evaluated. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990453 Thu, 31 Mar 2011 23:00:00 +0100 4990453 The challenges of undertaking root cause analysis in health care: a qualitative study http://www.medworm.com/index.php?rid=4990452&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F34%3Frss%3D1 Conclusions Health services leaders need to provide open endorsement of root cause analysis and of the staff carrying it out; enhance staff participation within learning activities and new analytic tools; and develop capabilities in change management. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990452 Thu, 31 Mar 2011 23:00:00 +0100 4990452 The association between presenteeism and engagement of National Health Service staff http://www.medworm.com/index.php?rid=4990451&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F29%3Frss%3D1 Conclusions Putting pressure on health-care staff to come to work when unwell is associated with poorer staff engagement with their jobs. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990451 Thu, 31 Mar 2011 23:00:00 +0100 4990451 The impact of patient choice of provider on equity: analysis of a patient survey http://www.medworm.com/index.php?rid=4990450&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F22%3Frss%3D1 Conclusions More educated, affluent patients were no more likely to be offered a choice than other population groups, but there does appear to be a social gradient in who chose to travel beyond the local area for treatment. If these results were replicated across England, there is at least the potential risk that when local hospitals are failing, patient choice could result in inequitable access to high quality care, rather than enhancing equity as the policy's architects had hoped. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990450 Thu, 31 Mar 2011 23:00:00 +0100 4990450 Governance for health and wellbeing in the English NHS http://www.medworm.com/index.php?rid=4990449&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F14%3Frss%3D1 Conclusions As the NHS in England undergoes further reorganization, it is important to ensure that a systematic, strategic and population-based approach to commissioning is not lost. Governance and incentive arrangements should be critically assessed for their impact on population health and wellbeing. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990449 Thu, 31 Mar 2011 23:00:00 +0100 4990449 Implementation of case management in long-term conditions in England: survey and case studies http://www.medworm.com/index.php?rid=4990448&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F8%3Frss%3D1 Conclusions Case management for patients with long-term conditions is at an early stage of development. Effective links with a range of local services are required if care plans are going to be comprehensive. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990448 Thu, 31 Mar 2011 23:00:00 +0100 4990448 Using intervention mapping to develop a family-based childhood weight management programme http://www.medworm.com/index.php?rid=4990447&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F2%3Frss%3D1 Conclusions Intervention mapping was a useful approach for developing a theory based intervention. Results suggest Y W8? improves the body mass index (BMI) of children and parents at 12 weeks. Further work, including a randomized controlled trial (RCT), will confirm this, investigate the longer-term effectiveness and determine how the effects are mediated by psychological processes. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990447 Thu, 31 Mar 2011 23:00:00 +0100 4990447 Health services research matters - more than ever http://www.medworm.com/index.php?rid=4990446&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2Fsuppl_1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4990446 Thu, 31 Mar 2011 23:00:00 +0100 4990446 Studentships and fellowships http://www.medworm.com/index.php?rid=4657356&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F126%3Frss%3D1 This edition of ‘What's on the web’ reviews websites that provide information about studentship and fellowship award schemes for both clinical and non-clinical researchers. The included organizations provide funding opportunities to researchers based in the UK and elsewhere at different stages of their research careers. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kate Light Information Specialist Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kate.light@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657356 Mon, 28 Mar 2011 23:00:00 +0100 4657356 Myth: Seeing a nurse practitioner instead of a doctor is second-class care http://www.medworm.com/index.php?rid=4657355&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F124%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657355 Mon, 28 Mar 2011 23:00:00 +0100 4657355 Cancer chronicity: new research and policy challenges http://www.medworm.com/index.php?rid=4657354&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F121%3Frss%3D1 Cancer centers are organized to serve the needs of patients who can benefit from medical and surgical interventions aimed at curing cancer and preventing recurrence. However, comprehensive cancer care must also encompass the needs of patients with incurable but treatable cancers, some of which can potentially be managed as chronic diseases through outpatient care and self-management. Treating cancer as a chronic disease, and helping patients to live with cancer as a chronic disease, calls for health care that complements services that exist for patients with curable disease, for patients who have completed treatment, and for patients whose disease no longer responds to treatment. Research should focus on the chronic cancer patients to understand how cancer treatment can better serve this g... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657354 Mon, 28 Mar 2011 23:00:00 +0100 4657354 Vigorous implementation of effective care can reduce inequalities in health http://www.medworm.com/index.php?rid=4657353&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F118%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657353 Mon, 28 Mar 2011 23:00:00 +0100 4657353 Do women consult more than men? A review of gender and consultation for back pain and headache http://www.medworm.com/index.php?rid=4657352&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F108%3Frss%3D1 Conclusion Given the strength of assumptions that women consult more readily for common symptoms, the evidence for greater consultation amongst women for two common symptoms, headache and back pain, was surprisingly weak and inconsistent, especially with respect to back pain. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657352 Mon, 28 Mar 2011 23:00:00 +0100 4657352 Patients' opinions of health care providers for supporting choice and quality improvement http://www.medworm.com/index.php?rid=4657351&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F102%3Frss%3D1 Patients are increasingly using the internet to access information on health care and services, as well as writing reviews of their own experiences. With patient choice increasing in many health systems, payers, purchasers and providers are attempting to take control of this trend by designing and managing their own patient opinion websites. This essay identifies and explores three aspects of online reviews of health care: the role of patients as judges of health care quality; the motivation behind patients posting reviews; and patients' use of such information. It then discusses how useful patient opinion websites might be in supporting patient choice in health care markets and in expanding voice channels for quality improvement. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657351 Mon, 28 Mar 2011 23:00:00 +0100 4657351 General practitioner commissioning consortia and budgetary risk: evidence from the modelling of 'fair share' practice budgets for mental health http://www.medworm.com/index.php?rid=4657350&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F95%3Frss%3D1 Conclusions Unless steps are taken to mitigate budgetary risk, the devolution of decision-making and introduction of fixed budgets is likely to result in significant financial instability. It will be difficult to reconcile the policy objectives of devolved commissioning, best met through relatively small and fully accountable consortia, with the need for financial stability, which is best met by pooling risk across larger populations. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657350 Mon, 28 Mar 2011 23:00:00 +0100 4657350 Use of secondary care in England by international immigrants http://www.medworm.com/index.php?rid=4657349&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F90%3Frss%3D1 Conclusions The assumption that international immigrants use more secondary care than the members of the indigenous population appears to be unfounded. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657349 Mon, 28 Mar 2011 23:00:00 +0100 4657349 Understanding public preferences for prioritizing health care interventions in England: does the type of health gain matter? http://www.medworm.com/index.php?rid=4657348&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F81%3Frss%3D1 Conclusions Aspects other than health gain need to be considered when soliciting the public's views of priorities for health care interventions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657348 Mon, 28 Mar 2011 23:00:00 +0100 4657348 Physician assistants in English general practice: a qualitative study of employers' viewpoints http://www.medworm.com/index.php?rid=4657347&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F75%3Frss%3D1 Conclusions General practice employers view PAs as a positive addition to a mixed skill team for meeting patient demand within a practice's finances. There is a need to develop stronger governance and regulatory frameworks for this emerging profession. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657347 Mon, 28 Mar 2011 23:00:00 +0100 4657347 Relational and management continuity survey in patients with multiple long-term conditions http://www.medworm.com/index.php?rid=4657346&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F67%3Frss%3D1 Conclusion People with many long-term conditions are at increased risk of inadequate management continuity with potential negative impacts on their care. Experiences of relational continuity, with potential buffering effects, are not associated with the number of long-term conditions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657346 Mon, 28 Mar 2011 23:00:00 +0100 4657346 Beyond Euro-centrism: health care reforms of seven small countries http://www.medworm.com/index.php?rid=4657345&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F2%2F65%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4657345 Mon, 28 Mar 2011 23:00:00 +0100 4657345 Open access research http://www.medworm.com/index.php?rid=4286940&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F62%3Frss%3D1 Open access makes research results available via the Internet without the user needing to have a subscription or to make a one-off payment to a publisher. This model of publication has resulted in the creation of both digital repositories and open access electronic journals. Material published using either of these routes is often free of restrictions in terms of both copyright and licensing. This edition of ‘What's on the web’ reviews three websites that look at different aspects of open access: developing open access repositories in universities, academic publishing and communication, and an example of an open access publisher. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kath Wright Information Service Mana... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286940 Fri, 24 Dec 2010 00:00:00 +0100 4286940 Health services research: rethinking the quest to be useful http://www.medworm.com/index.php?rid=4286939&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F59%3Frss%3D1 Health services research (HSR) is conceived as an applied discipline and studies are expected to be useful. Yet some of the most justly famous and important HSR has no tangible short-term impact. This raises the question of what constitutes ‘useful’ and whether it is possible to predict which studies will influence policy or practice. Attribution is also a constant issue: elements of health care systems change all the time and changes consistent with research findings may not signal causation but mere correlation. It is possible to make good changes in the absence of solid research evidence and it is also possible to make good changes while unaware of supportive research. Given these contingencies, it is worthwhile reflecting on the extent to which it is reasonable to expect HS... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286939 Fri, 24 Dec 2010 00:00:00 +0100 4286939 What evidence is there that a physiotherapy service in the emergency department improves health outcomes? A systematic review http://www.medworm.com/index.php?rid=4286938&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F51%3Frss%3D1 Conclusions Research evidence does not support the use of physiotherapists in emergency departments. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286938 Fri, 24 Dec 2010 00:00:00 +0100 4286938 Robots and service innovation in health care http://www.medworm.com/index.php?rid=4286937&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F46%3Frss%3D1 Robots have long captured our imagination and are being used increasingly in health care. In this paper we summarize, organize and criticize the health care robotics literature and highlight how the social and technical elements of robots iteratively influence and redefine each other. We suggest the need for increased emphasis on sociological dimensions of using robots, recognizing how social and work relations are restructured during changes in practice. Further, we propose the usefulness of a ‘service logic’ in providing insight as to how robots can influence health care innovation. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286937 Fri, 24 Dec 2010 00:00:00 +0100 4286937 Complexity in health care: a rejoinder http://www.medworm.com/index.php?rid=4286936&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F44%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286936 Fri, 24 Dec 2010 00:00:00 +0100 4286936 Storylines of self-management: narratives of people with diabetes from a multiethnic inner city population http://www.medworm.com/index.php?rid=4286935&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F37%3Frss%3D1 Conclusion Living with diabetes involves both medically recommended behaviours and complex biographical work to make sense of and cope with illness. Self-management education programmes should take closer account of over-arching storylines that pattern experience of chronic illness and recognize that some elements of self-management knowledge cannot be pre-specified in a structured curriculum. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286935 Fri, 24 Dec 2010 00:00:00 +0100 4286935 New models of self-management education for minority ethnic groups: pilot randomized trial of a story-sharing intervention http://www.medworm.com/index.php?rid=4286934&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F28%3Frss%3D1 Conclusion People from minority ethnic groups in a socioeconomically deprived area were keen to attend informal story-sharing groups and felt empowered by them, but clinical outcomes were no better than with conventional education. Further research is needed to maximize the potential and evaluate the place of this appealing service model before it is introduced as a part of mainstream diabetes services. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286934 Fri, 24 Dec 2010 00:00:00 +0100 4286934 Identifying poorly performing general practices in England: a longitudinal study using data from the quality and outcomes framework http://www.medworm.com/index.php?rid=4286933&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F21%3Frss%3D1 Conclusions A small minority of practices have remained poor performers in terms of measurable performance indicators over a four-year period. The strongest predictors of poor QOF performance were singlehanded and small practices, and practices staffed by elderly GPs. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286933 Fri, 24 Dec 2010 00:00:00 +0100 4286933 Respecting patient autonomy: understanding the impact on NHS hospital in-patients of legislation and guidance relating to patient capacity and consent http://www.medworm.com/index.php?rid=4286932&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F13%3Frss%3D1 Conclusions Patients were asked to make many varied decisions and the approaches taken by hospital staff differed depending on the nature of the decision and/or act in question. In contrast to personal care decisions, when health care practitioners approached patients in order to undertake routine acts of medical care, they generally did so in a manner that did not acknowledge that the patient had a right to exercise a choice. This is contrary to current law, policy and guidance. It seems to be rooted in the practical demands of running a hospital ward and uncertainties as to the purpose of securing patient consent before undertaking routine acts of medical care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286932 Fri, 24 Dec 2010 00:00:00 +0100 4286932 Senior-friendly emergency department care: an environmental assessment http://www.medworm.com/index.php?rid=4286931&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F6%3Frss%3D1 Conclusions The ED is an important part of seniors' health care. Changes to policy and practices, and enhanced education must occur to better meet the complex health care needs of seniors. This assessment provides a method that can be replicated elsewhere to generate site-specific recommendations and initiate capacity development processes to enhance senior-friendly care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286931 Fri, 24 Dec 2010 00:00:00 +0100 4286931 Audit of submissions: July 2009 to June 2010 http://www.medworm.com/index.php?rid=4286930&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F5%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286930 Fri, 24 Dec 2010 00:00:00 +0100 4286930 Health care reform in the Netherlands: the fairest of all? http://www.medworm.com/index.php?rid=4286929&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F3%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286929 Fri, 24 Dec 2010 00:00:00 +0100 4286929 Challenges for improving patients' experiences of health care http://www.medworm.com/index.php?rid=4286928&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F16%2F1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4286928 Fri, 24 Dec 2010 00:00:00 +0100 4286928 Health care blogs: finding, creating, examples http://www.medworm.com/index.php?rid=4000827&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F254%3Frss%3D1 Blogs are one of the new Web 2 tools that allow people to contribute to the Internet either by creating their own web pages or by commenting on other people's, without needing access to sophisticated software and technology. Typical features of a blog (or web log) include regular updating, chronological presentation of entries, an archive of older material, the facility for adding comment and a list of links to other websites (blogroll). Some blogs act as online diaries with personal opinions while others comment on a specific topic. Blogs can offer an alternative, less formal source of information about recent news events and current affairs that could be useful to health services researchers. This edition of ‘What's on the web’ helps you identify relevant blogs, create your o... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000827 Fri, 24 Sep 2010 17:29:55 +0100 4000827 Hospital mergers: a panacea? http://www.medworm.com/index.php?rid=4000826&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F251%3Frss%3D1 Hospital mergers in Europe and North America have been launched to scale down expenditure, enhance the delivery of health care and elevate quality. However, the outcome of mergers suggest that they neither generated cost savings nor improved the quality of care. Almost all consolidations fall short, since those in leadership positions lack the necessary understanding and appreciation of the differences in culture, values and goals of the existing facilities. In spite of these shortcomings, hospital mergers will continue to be pursued in order to improve market share, eliminate excess capacity, gain access to capital and enhance the personal egos of the organizations' leaders. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000826 Fri, 24 Sep 2010 17:29:55 +0100 4000826 Adopting and assimilating new non-pharmaceutical technologies into health care: a systematic review http://www.medworm.com/index.php?rid=4000825&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F243%3Frss%3D1 Conclusions Further process-based studies are needed to provide a clearer evidence base for recommendations on how to facilitate the adoption and assimilation of beneficial new technologies. Three theoretical perspectives could form the basis of such studies and produce practical advice for managers and practitioners. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000825 Fri, 24 Sep 2010 17:29:55 +0100 4000825 Gaming of performance measurement in health care: parallels with tax compliance http://www.medworm.com/index.php?rid=4000824&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F236%3Frss%3D1 Gaming of performance measurement in health care distorts performance, making it appear better than it is. This can conceal potentially hazardous practice and endanger patients and staff. Research has investigated and categorized this behaviour but as yet has offered little in the way of potential solutions as the drivers are still not well understood. Studies of the psychology of tax behaviour, specifically tax avoidance and evasion, reveal some insights into what the underlying causes are. Looking at health care and tax compliance, seven similarities in response can be detected: negative view of those subject to it; not salient except for specific classes of people; general understanding of the need versus resentment of actuality; cognitive dissonance; moral versus legal grey areas; two ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000824 Fri, 24 Sep 2010 17:29:55 +0100 4000824 'Not quite Jericho, but more doors than there used to be'. Staff views of the impact of 'modernization' on boundaries around adult critical care services in England http://www.medworm.com/index.php?rid=4000823&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F229%3Frss%3D1 Conclusions Policies to remove boundaries around adult critical care are perceived to have had a dramatic impact on the organization of the service. Considerable progress was reported towards developing comprehensive critical care services both within and between hospitals. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000823 Fri, 24 Sep 2010 17:29:55 +0100 4000823 Diagnosing diabetes in disadvantaged populations: the role of social participation http://www.medworm.com/index.php?rid=4000822&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F223%3Frss%3D1 Conclusions People with diabetes who had low incomes and who did not graduate from high school were more likely to know they had diabetes if they had more frequent social interaction. Clarifying the mechanisms through which social participation affects the diagnosis of diabetes may help in developing strategies to improve diabetes identification. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000822 Fri, 24 Sep 2010 17:29:55 +0100 4000822 Acceptability of community pharmaceutical care in Portugal: a qualitative study http://www.medworm.com/index.php?rid=4000821&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F215%3Frss%3D1 Conclusions Acceptability to patients is mainly determined by perceptions of convenient access and the development of a therapeutic relationship with the pharmacist. Patients' expectations concerning the service are not well developed, but not necessarily low. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000821 Fri, 24 Sep 2010 17:29:55 +0100 4000821 Who's that sleeping in my bed? Potential and actual utilization of public and private in-patient beds in Irish acute public hospitals http://www.medworm.com/index.php?rid=4000820&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F210%3Frss%3D1 Conclusions Despite policies designed to limit private practice in Irish acute public hospitals, some hospitals have apparently been able to overcome these restrictions. In a system where financial incentives to treat private patients exist both for consultants and hospitals, it is not clear whether this excess private practice in public hospitals reflects a more efficient utilization of resources (when demand from public patients is low) or the displacement of public patients in favour of private patients. However, that a smaller number on hospital waiting lists possess private health insurance provides some support for the displacement hypothesis. Thus, it appears that policy-makers may need to reconsider attempts to ensure an appropriate division of acute public hospital resources betwe... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000820 Fri, 24 Sep 2010 17:29:55 +0100 4000820 Is there an association between the quality of hospitals' research and their quality of care? http://www.medworm.com/index.php?rid=4000819&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F204%3Frss%3D1 Conclusions Measures of research output could be considered for incorporation into comparisons of the quality of hospitals. A weighted citations ratio is the most suitable measure of research output, but more research is needed on the interplay between research and practice as complementary ways of developing medical knowledge. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000819 Fri, 24 Sep 2010 17:29:55 +0100 4000819 Evaluation of international recruitment of health professionals in England http://www.medworm.com/index.php?rid=4000818&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F195%3Frss%3D1 Conclusions The main achievement of the intensive international recruitment period from a UK viewpoint was that such a major undertaking was seen through without major disruption to NHS services. The wider costs and challenges meant, however, that large-scale international recruitment was not sustainable as a solution to workforce shortages. Should such approaches be attempted in future, a clearer upfront appraisal of all the potential costs and implications will be vital. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000818 Fri, 24 Sep 2010 17:29:55 +0100 4000818 Australian health care reform: giant leap or small step? http://www.medworm.com/index.php?rid=4000817&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F4%2F193%3Frss%3D1 (No summary is available for this citation) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=4000817 Fri, 24 Sep 2010 17:29:55 +0100 4000817 Patient opinion http://www.medworm.com/index.php?rid=3670233&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F190%3Frss%3D1 A number of websites now offer patients the opportunity to give their opinion on the quality of the health services they have received. These comments and criticisms can offer a valuable alternative source of information to that provided by quantitative websites. Patient views and experiences can also provide the impetus for providers to improve the quality of their services. This edition of ‘What's on the web’ collects together and compares some of these websites. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to:Kath Wright Information Service Manager Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kew5@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670233 Wed, 16 Jun 2010 23:47:47 +0100 3670233 Myth: Emergency room overcrowding is caused by non-urgent cases http://www.medworm.com/index.php?rid=3670232&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F188%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670232 Wed, 16 Jun 2010 23:47:47 +0100 3670232 Health services research in sub-Saharan Africa: thirty recommended examples http://www.medworm.com/index.php?rid=3670231&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F185%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670231 Wed, 16 Jun 2010 23:47:47 +0100 3670231 Impact of pay for performance on inequalities in health care: systematic review http://www.medworm.com/index.php?rid=3670230&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F178%3Frss%3D1 Conclusion Inequalities in chronic disease management have largely persisted after the introduction of the Quality and Outcome Framework. Pay for performance programmes should be designed to reduce inequalities as well as improve the overall quality of care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670230 Wed, 16 Jun 2010 23:47:47 +0100 3670230 The emotional experience of patient care: a case for innovation in health care design http://www.medworm.com/index.php?rid=3670229&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F174%3Frss%3D1 This paper considers recent developments in health care facility design and in the psychology literature that support a case for increased design sensitivity to the emotional experience of patient care. The author discusses several examples of innovative patient-centred health care design interventions. These generally resulted in improvements in the patient and staff experience of care, at less cost than major infrastructural interventions. The paper relates these developments in practice with recent neuroscience research, illustrating that the design of the built environment influences patient emotional stress. In turn, patient emotional stress appears to influence patient satisfaction, and in some instances, patient outcomes. This paper highlights the need for further research in this a... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670229 Wed, 16 Jun 2010 23:47:47 +0100 3670229 The NHS as an insurer http://www.medworm.com/index.php?rid=3670228&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F171%3Frss%3D1 The National Health Service (NHS) in England is not only a commissioner and provider of health care to the sick, but also offers certainty and peace of mind to all citizens – even those who do not use the health service in any year. However, due to the recent dominance of cost-effectiveness and cost-utility analysis as the central factors determining resource allocation decisions in the NHS, this second role — which we term its ‘insurance value’ — has increasingly become neglected. In this paper, we argue that this inattention is detrimental to the population at large. We explore some implications to the NHS of maximizing insurance value. These include requiring commissioners to take explicit account of how denial of service undermines peace of mind; requiring... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670228 Wed, 16 Jun 2010 23:47:47 +0100 3670228 Patients' experiences of an intervention to support tuberculosis treatment adherence in South Africa http://www.medworm.com/index.php?rid=3670227&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F163%3Frss%3D1 Conclusion The study suggests that differences remain between the ART approach and the new TB treatment model. While the new programme seems to have succeeded in providing additional information, it is not clear that it substantially changed patient agency over their treatment taking in this setting. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670227 Wed, 16 Jun 2010 23:47:47 +0100 3670227 'You need that loving tender care': maternity care experiences and expectations of ethnic minority women born in the United Kingdom http://www.medworm.com/index.php?rid=3670226&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F156%3Frss%3D1 Conclusions Our findings contribute to the growing evidence about the need to improve maternity and postnatal care, and to develop more sensitive and women-centred care for all women irrespective of ethnic background. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670226 Wed, 16 Jun 2010 23:47:47 +0100 3670226 Can a health forecasting service offer COPD patients a novel way to manage their condition? http://www.medworm.com/index.php?rid=3670225&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F150%3Frss%3D1 Conclusions Patients found the automated interactive calling, combined with a health risk forecast, both viable and useful, welcoming the information and tools it offered. In many cases, it added to patients’ understanding of their illness and promoted better self-management. Future research should focus on the potential impact of the service in terms of health outcomes and cost-effectiveness. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670225 Wed, 16 Jun 2010 23:47:47 +0100 3670225 Cost-effectiveness of a programme to detect and provide better care for female victims of intimate partner violence http://www.medworm.com/index.php?rid=3670224&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F143%3Frss%3D1 Conclusions While there is considerable uncertainty in the underlying parameters, a training programme for primary care teams to increase identification and referral of women experiencing IPV is likely to be cost-effective. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670224 Wed, 16 Jun 2010 23:47:47 +0100 3670224 Negotiating care: patient tactics at an urban South African hospital http://www.medworm.com/index.php?rid=3670223&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F137%3Frss%3D1 Conclusion Patients made tactical use of small spaces at the margins of the health care system. Although, with some exceptions, they had limited impact on the care received in the hospital, they highlight patients as active players and point to the ways in which patient agency can be strengthened in the light of the shift towards chronic disease care and greater patient involvement in care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670223 Wed, 16 Jun 2010 23:47:47 +0100 3670223 Difficulties of tracing health research funded by the European Union http://www.medworm.com/index.php?rid=3670222&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F133%3Frss%3D1 Conclusions CORDIS does not meet its stated objectives of facilitating and disseminating EU research. There is a clear need to review the systems designed to manage the CORDIS platform. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670222 Wed, 16 Jun 2010 23:47:47 +0100 3670222 Financial incentives to change patient behaviour http://www.medworm.com/index.php?rid=3670221&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F131%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670221 Wed, 16 Jun 2010 23:47:47 +0100 3670221 The poor may always be with us but we don't know how many or where they are http://www.medworm.com/index.php?rid=3670220&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F3%2F129%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670220 Wed, 16 Jun 2010 23:47:47 +0100 3670220 HIV testing of health care workers in England - a flawed policy http://www.medworm.com/index.php?rid=3670243&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F62%3Frss%3D1 A new Department of Health policy in England, published in 2007, recommended changes to the pre-employment health checks performed on health care workers before taking up their employment. The policy proposed that all new health care workers should receive immunization against TB and hepatitis B and should be offered testing for hepatitis C and HIV. It also advanced a new requirement that staff who perform exposure-prone procedures must be tested for TB, hepatitis B and C and HIV and must test negative for these diseases. Essentially mandatory HIV testing has been introduced for a large number of health care workers. The aim of the recommendations is to protect patients from contracting serious communicable diseases from health care professionals. Secondary objectives of the directive are ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670243 Tue, 30 Mar 2010 15:29:38 +0100 3670243 Cancer patients' experiences of using complementary therapies: polarization and integration http://www.medworm.com/index.php?rid=3670242&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F54%3Frss%3D1 Conclusions Our findings suggest that the current polarized situation is unhelpful to patients, detrimental to therapeutic relationships and may occasionally be dangerous. They indicate that complementary therapies, in a supportive role, should be integrated into mainstream cancer care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670242 Tue, 30 Mar 2010 15:29:38 +0100 3670242 Patients' perspectives on cardiac rehabilitation, lifestyle change and taking medicines: implications for service development http://www.medworm.com/index.php?rid=3670241&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F47%3Frss%3D1 Conclusion Ensuring that individual patients' information needs about medicines and lifestyle are adequately met remains a key focus for cardiac rehabilitation development. Key aspects include individualizing information and actively seeking and responding to patients' needs during and after cardiac rehabilitation. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670241 Tue, 30 Mar 2010 15:29:38 +0100 3670241 Patients' and staffs' experiences of an automated telephone weather forecasting service http://www.medworm.com/index.php?rid=3670240&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F41%3Frss%3D1 Conclusions An automated telephone service was generally acceptable to patients but changes in COPD management were limited, possibly because the patients already had a good understanding of their condition and self-management strategies. Implications for practice include the need for strategies to target hard-to-reach groups which may need more resources. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670240 Tue, 30 Mar 2010 15:29:38 +0100 3670240 Economic consequences for other family members of mental health problems in older people http://www.medworm.com/index.php?rid=3670239&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F35%3Frss%3D1 Conclusions Mental health problems among older family members are associated with significant labour market effects for younger family members. To reduce the economic consequences, better assessment of mental health among older people may be warranted. Further employment support for younger family members, in the form of more flexible work policies, might also serve to ameliorate economic losses. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670239 Tue, 30 Mar 2010 15:29:38 +0100 3670239 When policy meets the personal: general practice nurses in Australia http://www.medworm.com/index.php?rid=3670238&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F26%3Frss%3D1 Conclusion Policy development and funding structures would benefit from better understanding of nurses as agents of connectivity (rather than simply as performers of tasks) as well as the nature of teamwork in practices. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670238 Tue, 30 Mar 2010 15:29:38 +0100 3670238 Complexity and whole-system change programmes http://www.medworm.com/index.php?rid=3670237&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F19%3Frss%3D1 Conclusions The programme worked well to improve performance by focusing on interdependencies within a large part of the acute care subsystem but did not have the same impact at the overall health care system level. This has important implications for the design of policy and associated programmes which seek to effect whole system reform, or at least are realistic about the magnitude of change they can achieve. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670237 Tue, 30 Mar 2010 15:29:38 +0100 3670237 Consensus methods to identify a set of potential performance indicators for systems of emergency and urgent care http://www.medworm.com/index.php?rid=3670236&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F12%3Frss%3D1 Conclusions System-wide measures to monitor performance across multiple services should encourage providers to work for patient benefit in an integrated way. They will also assist commissioners to monitor and improve emergency and urgent care for their local populations. The indicators are now being calculated using routinely available data, and tested for their responsiveness to capture change over time. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670236 Tue, 30 Mar 2010 15:29:38 +0100 3670236 Local decision-makers views' of national guidance on interventional procedures in the UK http://www.medworm.com/index.php?rid=3670235&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F3%3Frss%3D1 Conclusions Management of interventional procedures guidance in the NHS can be improved. It is important to understand the ways in which guidance meets and fails to meet decision-makers' needs. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670235 Tue, 30 Mar 2010 15:29:38 +0100 3670235 Research that is both rigorous and useful http://www.medworm.com/index.php?rid=3670234&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_2%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3670234 Tue, 30 Mar 2010 15:29:38 +0100 3670234 Patient information websites http://www.medworm.com/index.php?rid=3407211&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F126%3Frss%3D1 have become one of the main means of providing advice and information to individuals. The range of topics covered and the reliability of the information provided means that they can also be a valuable resource to practitioners and researchers. We first reviewed patient information websites in 2003 and this column updates that review. One of the developments since then is that information is now being presented using visual resources, such as podcasts and video clips, as well as text. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kath Wright Information Service Manager Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kew5@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407211 Thu, 25 Mar 2010 21:24:17 +0100 3407211 Thematic analysis and its reconceptualization as 'saliency analysis' http://www.medworm.com/index.php?rid=3407210&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F123%3Frss%3D1 Thematic analysis is characteristic of most qualitative research. Themes are groups of codes that recur through being similar or connected to each other in a patterned way. Thematic analysis ignores codes that do not recur yet may nonetheless be important. This paper proposes the concept of ‘saliency analysis’ as an enhancement of thematic analysis. Saliency analysis assesses the degree to which each code recurs, is highly important or both. Codes of high importance are ones that advance understanding or are useful in addressing real world problems, or both. Thus saliency analysis can expose what is non-recurrent but potentially important to the aims of a study. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407210 Thu, 25 Mar 2010 21:24:17 +0100 3407210 Diagnosis in general practice and its implications for quality of care http://www.medworm.com/index.php?rid=3407209&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F120%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407209 Thu, 25 Mar 2010 21:24:17 +0100 3407209 Myth: whole-body screening is an effective way to detect hidden cancers http://www.medworm.com/index.php?rid=3407208&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F118%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407208 Thu, 25 Mar 2010 21:24:17 +0100 3407208 Response to 'The appropriation of complexity theory in health care' http://www.medworm.com/index.php?rid=3407207&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F115%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407207 Thu, 25 Mar 2010 21:24:17 +0100 3407207 Determinants of self-reported medicine underuse due to cost: a comparison of seven countries http://www.medworm.com/index.php?rid=3407206&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F106%3Frss%3D1 Conclusions Cost-related underuse of medicines was least commonly reported in countries with the lowest out-of-pocket costs, the Netherlands and the UK. Countries with reduced co-payments or cost ceilings for low income patients showed the least disparity in rates of underuse between income groups. Despite differences in health insurance systems in these countries, age, ethnicity, depression, and involvement with treatment decisions were consistently predictive of underuse. There are opportunities for policy makers and clinicians to support medicine use in vulnerable groups. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407206 Thu, 25 Mar 2010 21:24:17 +0100 3407206 Impact of clinician judgement on formulary committees' recommendations in Canada http://www.medworm.com/index.php?rid=3407205&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F98%3Frss%3D1 Conclusions Clinician judgement about the efficacy of medications can influence formulary committee recommendations. This suggests the need for a new approach to govern the consideration of expert evidence during formulary committee deliberations. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407205 Thu, 25 Mar 2010 21:24:17 +0100 3407205 Genetic screening: a conceptual framework for programmes and policy-making http://www.medworm.com/index.php?rid=3407204&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F90%3Frss%3D1 Conclusion This framework can support policy-makers by fostering a common understanding and facilitating dialogue with stakeholders. The framework has also been used as the conceptual foundation for the development of a more elaborate decision-guide. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407204 Thu, 25 Mar 2010 21:24:17 +0100 3407204 Accountability of foundation trusts in the English NHS: views of directors and governors http://www.medworm.com/index.php?rid=3407203&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F82%3Frss%3D1 Conclusions Contrary to the major policy objectives of giving greater autonomy to foundation trusts and making them more accountable to the local population, they continue to look towards the Department of Health rather than to the local population and its representatives. The accountability of foundation trusts needs to be simplified, clarified and strengthened. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407203 Thu, 25 Mar 2010 21:24:17 +0100 3407203 Why patients of low socioeconomic status with mental health problems have shorter consultations with general practitioners http://www.medworm.com/index.php?rid=3407202&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F76%3Frss%3D1 Conclusion The shortness of the consultation length is due to a supply-side effect, implicating dissatisfaction for patients with mental health problems. This may not be generalizable to other patients. Findings are in favour of a specific intervention aimed at giving poor people equal access to GPs' time. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407202 Thu, 25 Mar 2010 21:24:17 +0100 3407202 Cost and impact of a quality improvement programme in mental health services http://www.medworm.com/index.php?rid=3407201&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F69%3Frss%3D1 Conclusions Given the difficult contexts, short time-scales and capacity constraints, the programme's lack of impact is not surprising. It may, however, represent a worthwhile investment in cultural change which might facilitate improvements in how services are delivered. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407201 Thu, 25 Mar 2010 21:24:17 +0100 3407201 Impact of devolution of health care in the UK: provider challenge in England and provider capture in Wales, Scotland and Northern Ireland? http://www.medworm.com/index.php?rid=3407200&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F67%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407200 Thu, 25 Mar 2010 21:24:17 +0100 3407200 Political accountability of explicit rationing: legitimacy problems faced by NICE http://www.medworm.com/index.php?rid=3407199&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F2%2F65%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407199 Thu, 25 Mar 2010 21:24:17 +0100 3407199 Patient safety research in the UK and beyond: 10 years of research and policy to make health care safer http://www.medworm.com/index.php?rid=3407231&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F87%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407231 Thu, 14 Jan 2010 15:53:17 +0100 3407231 How well do NHS trusts react to patient safety alerts? http://www.medworm.com/index.php?rid=3407230&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F83%3Frss%3D1 The study, first published in 2007, used several methods to study the nature of patient safety alerts, find out how trusts received and implemented them, assessed their impact and recommended improvements. Methods included surveys and interviews of staff at different levels from 41 NHS organizations and an in-depth study of 11 alerts. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407230 Thu, 14 Jan 2010 15:53:17 +0100 3407230 Testing new devices to help prevent 'misconnection' errors in health care http://www.medworm.com/index.php?rid=3407229&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F79%3Frss%3D1 The study, the first part of which was published in 2008, looked at, prospectively, how effective and safe new, non-traditional connectors were for use in spinal connector equipment such as spinal needles and infusion lines. The researchers analysed existing evidence on adverse incidents in this area, held workshops to discuss the problem, tested new devices with a simulator, and evaluated them in clinical practice trials at four different hospitals in England. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407229 Thu, 14 Jan 2010 15:53:17 +0100 3407229 Feedback from reporting patient safety incidents - are NHS trusts learning lessons? http://www.medworm.com/index.php?rid=3407228&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F75%3Frss%3D1 For the study, first published in 2006, the researchers examined how well NHS organisations had attempted to use the information they gathered from adverse clinical incidents and whether they were learning from it. By looking at existing relevant research worldwide, interviewing experts, surveying NHS organizations (acute, community and ambulance), consulting health care and other high-risk industry safety experts and NHS risk managers, and investigating case studies of good practice, they developed a model to assess how ready NHS systems were to learn from incidents. This is known as Safety Action and Information Feedback from Incident Reporting (SAIFIR). (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407228 Thu, 14 Jan 2010 15:53:17 +0100 3407228 Diagnosis of difficult cases in primary care http://www.medworm.com/index.php?rid=3407227&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F71%3Frss%3D1 The study, first published in 2008, involved GPs of different levels of experience taking part in a study that used hypothetical clinical scenarios in order to look at what it is that leads GPs to make diagnosis errors and whether there are common characteristics of diseases that GPs might often miss. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407227 Thu, 14 Jan 2010 15:53:17 +0100 3407227 Ways to reduce drug dose calculation errors in children http://www.medworm.com/index.php?rid=3407226&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F68%3Frss%3D1 The study, first published in 2007, tried to identify interventions introduced to reduce dose calculation errors in newborn infant and child patients and then to assess their impact on patient care. To do this, the researchers studied existing research, surveyed health care professionals, observed selected interventions and then attempted to do an economic analysis of the most promising interventions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407226 Thu, 14 Jan 2010 15:53:17 +0100 3407226 Electronic prescribing - safer, faster, better? http://www.medworm.com/index.php?rid=3407225&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F64%3Frss%3D1 The study, first published in 2006, looks at how we should evaluate electronic prescribing systems in hospitals, particularly to improve patient safety. It provides an evaluation framework, compares methodologies to detect prescribing errors and describes the advantages of approaching evaluation of these systems from a sociotechnical perspective. Two electronic prescribing systems are studied using simultaneous quantitative and qualitative approaches. Electronic prescribing systems can reduce the incidence of prescribing error, however their implementation is not straight forward and they should be considered a constant ‘work in progress’. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407225 Thu, 14 Jan 2010 15:53:17 +0100 3407225 Medication errors - what is the best way to reduce their impact on patients' health? http://www.medworm.com/index.php?rid=3407224&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F60%3Frss%3D1 The study, first released in 2005, looks at medication errors and how they can be reduced. The authors carried out a prospective hazard and improvement analysis, which involved a review of existing research, analysis of existing evidence by experts and calculation of the benefits and costs of three interventions that might reduce the number of medication incidents. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407224 Thu, 14 Jan 2010 15:53:17 +0100 3407224 Communication with patients after errors http://www.medworm.com/index.php?rid=3407223&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F56%3Frss%3D1 The study, published in 2003, looks at more than 120 sources of existing research, studies, and policies to consider errors and adverse incidents, particularly involving doctors, and the quality of communication with patients after an incident has happened. The researchers, however, said the research evidence was inadequate and nothing was clear cut. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407223 Thu, 14 Jan 2010 15:53:17 +0100 3407223 Failures in childbirth care http://www.medworm.com/index.php?rid=3407222&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F52%3Frss%3D1 The study, first published in 2003, looks at the root causes of adverse events and near misses in obstetrics at seven hospital maternity units by interviewing 93 members of staff, identifying the areas of mismanagement in each case and thematically analysing them. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407222 Thu, 14 Jan 2010 15:53:17 +0100 3407222 Errors in the operating theatre - how to spot and stop them http://www.medworm.com/index.php?rid=3407221&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F48%3Frss%3D1 The study, first published in 2005, looks at errors made in the operating theatre by observing operations at first hand, recording them for closer scrutiny and evaluation of non-technical skills such as human error, system problems and teamwork, questioning health professionals to assess safety culture, and using computer simulations to study how hospital systems might increase the chances of surgical error. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407221 Thu, 14 Jan 2010 15:53:17 +0100 3407221 Safety alerts on drugs - how trusts follow the rules http://www.medworm.com/index.php?rid=3407220&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F44%3Frss%3D1 The study, first published in 2003, looks at how trusts reacted to and implemented a safety alert on a drug, in this case potassium chloride, which can help save lives, but which is dangerous in high concentrations. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407220 Thu, 14 Jan 2010 15:53:17 +0100 3407220 How to improve patient safety in surgery http://www.medworm.com/index.php?rid=3407219&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F40%3Frss%3D1 The study, first published in 2006, looks at patient safety from the perspective of surgery, looking at surgeons' technical skills, surgical team performance in the operating theatre, the team's views of their performance, interruptions and distractions, and multidisciplinary team training in surgery using simulated training scenarios. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407219 Thu, 14 Jan 2010 15:53:17 +0100 3407219 How effective is training to help staff deal with obstetric emergencies http://www.medworm.com/index.php?rid=3407218&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F37%3Frss%3D1 The study, first published in 2008, examined the efficacy of drill training for staff in dealing with obstetric emergencies; specifically whether it improved their skills and performance. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407218 Thu, 14 Jan 2010 15:53:17 +0100 3407218 Patient safety - what claims against the NHS can teach us http://www.medworm.com/index.php?rid=3407217&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F33%3Frss%3D1 The study, first published in 2004, looks at databases on clinical negligence litigation, what kind of claims for clinical negligence there have been, and studies cases in different settings such as general practice, general surgery and medicine, psychiatry and obstetrics. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407217 Thu, 14 Jan 2010 15:53:17 +0100 3407217 Narrative review of the UK Patient Safety Research Portfolio http://www.medworm.com/index.php?rid=3407216&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F26%3Frss%3D1 Conclusions The PSRP has provided the foundations for significant theoretical, methodological and empirical advances in the area of patient safety. The findings and recommendations make important contributions to policy formulation and implementation as well as professional and managerial practice. Through this body of research the PSRP has supported the formation and growth of a thriving research community across academic, policy and professional communities. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407216 Thu, 14 Jan 2010 15:53:17 +0100 3407216 Scoping review and approach to appraisal of interventions intended to involve patients in patient safety http://www.medworm.com/index.php?rid=3407215&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F17%3Frss%3D1 Conclusions An approach for appraising interventions intended to promote patient involvement in patient safety should involve: identification of the routes by which interventions assume patients’ actions might contribute to their safety; identification of the conditions that would need to be met for patients to behave and contribute as the interventions (implicitly) assume; examination of the extent to which the intervention supports fulfilment of those conditions; and consideration of the potential negative effects of the intervention. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407215 Thu, 14 Jan 2010 15:53:17 +0100 3407215 Why is patient safety so hard? A selective review of ethnographic studies http://www.medworm.com/index.php?rid=3407214&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F11%3Frss%3D1 Ethnographic studies are valuable in studying patient safety. This is a narrative review of four reports of ethnographic studies of patient safety in UK hospitals conducted as part of the Patient Safety Research Programme. Three of these studies were undertaken in operating theatres and one in an A&E Department. The studies found that hospitals were rarely geared towards ensuring perfect performances. The coordination and mobilization of the large number of inter-dependent processes and resources needed to support the achievement of tasks was rarely optimal. This produced significant strain that staff learned to tolerate by developing various compensatory strategies. Teamwork and inter-professional communication did not always function sufficiently well to ensure that basic procedural ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407214 Thu, 14 Jan 2010 15:53:17 +0100 3407214 Learning about patient safety: organizational context and culture in the education of health care professionals http://www.medworm.com/index.php?rid=3407213&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F4%3Frss%3D1 Conclusions Action is needed to develop an efficient interface between employers and education providers to develop up-to-date curricula for patient safety. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407213 Thu, 14 Jan 2010 15:53:17 +0100 3407213 The English Patient Safety Research Programme: a commissioner's tale http://www.medworm.com/index.php?rid=3407212&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2Fsuppl_1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3407212 Thu, 14 Jan 2010 15:53:17 +0100 3407212 Population health: data, trends and indicators http://www.medworm.com/index.php?rid=3170468&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F62%3Frss%3D1 Several websites provide information about the health of the population including health indicators at regional and district levels. These allow health services researchers to access comparable statistics for different countries. This edition of ‘What's on the web’ lists some of the websites that provide easy access to reliable population health data and statistics. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kath Wright Information Service Manager Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kew5@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170468 Wed, 13 Jan 2010 17:42:59 +0100 3170468