Jim Swift, Selma Abed, J. Hall, Jimmy Cheung, Keith Pearson, Chris Baker
This is a follow-up study to research published in 2017, which evaluated the effectiveness of an audit and change programme aiming to improve the cost-effectiveness of self-monitoring of blood glucose prescribing in two Greater Manchester clinical commissioning groups. The present study aimed to assess the longevity of the changes achieved over a 6-year period, comparing clinical commissioning groups that adopted the change programme in 2015 with those that adopted it later or not at all in Greater Manchester. Prescribing data for Greater Manchester were extracted from a publicly available database and categorised into three groups: clinical commissioning groups that adopted a medicines optimisation programme in 2015, those that adopted it later and those that did not adopt the programme. The savings of each clinical commissioning group were balanced using diabetes prevalence data and compared against an average clinical commissioning group in England. Data were compared using Kruskal Wallis tests, post-hoc Dunn's tests, Mann-Whitney U tests and linear regression. Clinical commissioning groups that implemented the change programme in 2015 had greater savings than those that did not implement the change programme (P=0.0036). The former group also saw greater percentage reductions in mean self-monitoring of blood glucose unit costs than the NHS England average (29.6% vs 20.3%; P<0.001) between the fourth quarter of 2014 and the fourth quarter of 2020. A structured change programme that aims to standardise prescribing can lead to substantial cost savings over a time period of 6 years.
{"title":"Medical device standardisation for diabetes: a 6–year evaluation of cost savings","authors":"Jim Swift, Selma Abed, J. Hall, Jimmy Cheung, Keith Pearson, Chris Baker","doi":"10.12968/bjhc.2021.0160","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0160","url":null,"abstract":"This is a follow-up study to research published in 2017, which evaluated the effectiveness of an audit and change programme aiming to improve the cost-effectiveness of self-monitoring of blood glucose prescribing in two Greater Manchester clinical commissioning groups. The present study aimed to assess the longevity of the changes achieved over a 6-year period, comparing clinical commissioning groups that adopted the change programme in 2015 with those that adopted it later or not at all in Greater Manchester. Prescribing data for Greater Manchester were extracted from a publicly available database and categorised into three groups: clinical commissioning groups that adopted a medicines optimisation programme in 2015, those that adopted it later and those that did not adopt the programme. The savings of each clinical commissioning group were balanced using diabetes prevalence data and compared against an average clinical commissioning group in England. Data were compared using Kruskal Wallis tests, post-hoc Dunn's tests, Mann-Whitney U tests and linear regression. Clinical commissioning groups that implemented the change programme in 2015 had greater savings than those that did not implement the change programme (P=0.0036). The former group also saw greater percentage reductions in mean self-monitoring of blood glucose unit costs than the NHS England average (29.6% vs 20.3%; P<0.001) between the fourth quarter of 2014 and the fourth quarter of 2020. A structured change programme that aims to standardise prescribing can lead to substantial cost savings over a time period of 6 years.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47594546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Annemarie Brown discusses patient and cost implications of chronic, hard-to-heal wounds, and provides an overview of the TIMERS tool, which should be used to guide the delivery of effective, holistic care.
{"title":"Effective care for patients with chronic wounds: a manager's guide to the TIMERS tool","authors":"Annemarie Brown","doi":"10.12968/bjhc.2023.0030","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0030","url":null,"abstract":"Annemarie Brown discusses patient and cost implications of chronic, hard-to-heal wounds, and provides an overview of the TIMERS tool, which should be used to guide the delivery of effective, holistic care.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48258929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rania Ali Albsoul, G. Fitzgerald, J. Hughes, M. Alshyyab
Falls are a key patient safety concern because of the associated physical injuries, emotional impact and financial burden on patients and the healthcare system. This study aimed to describe the characteristics of falls and assess the potential risk factors among hospitalised patients in a medium-sized acute care hospital in Queensland, Australia. This was a retrospective descriptive study using routinely collected information. The study was conducted in a medium-sized public hospital in Queensland, Australia. Characteristics of patients, their fall risk classification and circumstances of patient falls were extracted from the incident report provided by the hospital. Data were analysed using descriptive statistics. A total of 677 patient fall incidents were documented on the hospital's electronic incident system from 2015–17. The majority of falls (98%) occurred in inpatient units and caused no or minimal harm to patients. Older age groups (75–84 years and 85–94 years) made up the greatest proportion of patients who fell. Falls were largely related to toileting activities. The most common locations for inpatient falls were the bed, bedside trolley or treatment chair. Intervention studies are needed to develop and evaluate procedures to prevent falls, particularly for activities with a high risk of falls, such as toileting, and for older patients.
{"title":"Risk factors for in-hospital patient falls: a retrospective analysis","authors":"Rania Ali Albsoul, G. Fitzgerald, J. Hughes, M. Alshyyab","doi":"10.12968/bjhc.2021.0148","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0148","url":null,"abstract":"Falls are a key patient safety concern because of the associated physical injuries, emotional impact and financial burden on patients and the healthcare system. This study aimed to describe the characteristics of falls and assess the potential risk factors among hospitalised patients in a medium-sized acute care hospital in Queensland, Australia. This was a retrospective descriptive study using routinely collected information. The study was conducted in a medium-sized public hospital in Queensland, Australia. Characteristics of patients, their fall risk classification and circumstances of patient falls were extracted from the incident report provided by the hospital. Data were analysed using descriptive statistics. A total of 677 patient fall incidents were documented on the hospital's electronic incident system from 2015–17. The majority of falls (98%) occurred in inpatient units and caused no or minimal harm to patients. Older age groups (75–84 years and 85–94 years) made up the greatest proportion of patients who fell. Falls were largely related to toileting activities. The most common locations for inpatient falls were the bed, bedside trolley or treatment chair. Intervention studies are needed to develop and evaluate procedures to prevent falls, particularly for activities with a high risk of falls, such as toileting, and for older patients.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43921500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Healthcare professionals are at risk of experiencing sexual harassment at work, which can have a negative impact on their health and wellbeing. This study aimed to explore the reasons why healthcare professionals may not report their experiences of sexual harassment, as documented in peer-reviewed literature. EBSCO, Scopus, JSTOR, Science Direct, Sage, Google Scholar, the Cochrane Library and DelphiS were searched to identify relevant articles published in English from Australia, Canada, Ireland, New Zealand, UK and USA. A concept mapping table was developed to assist with the search strategy and the Critical Skills Appraisal Programme Checklist was used to critique and synthesise the findings. A total of five articles met the inclusion criteria, although most focused on healthcare professionals in general and looked at wider harassment and violence, rather than sexual harassment alone. The main factors that influenced the reporting of harassment were the normalisation of inappropriate behaviour, fear of reprisal and lack of clarity around policies and procedures. Further research is needed into the factors influencing the reporting of sexual harassment specifically in order to develop standardised reporting procedures and training programmes to prevent these incidents, and handle them appropriately when they do occur.
{"title":"Barriers to reporting sexual harassment in healthcare settings: a literature review","authors":"Tabitha Morgan Rees","doi":"10.12968/bjhc.2022.0035","DOIUrl":"https://doi.org/10.12968/bjhc.2022.0035","url":null,"abstract":"Healthcare professionals are at risk of experiencing sexual harassment at work, which can have a negative impact on their health and wellbeing. This study aimed to explore the reasons why healthcare professionals may not report their experiences of sexual harassment, as documented in peer-reviewed literature. EBSCO, Scopus, JSTOR, Science Direct, Sage, Google Scholar, the Cochrane Library and DelphiS were searched to identify relevant articles published in English from Australia, Canada, Ireland, New Zealand, UK and USA. A concept mapping table was developed to assist with the search strategy and the Critical Skills Appraisal Programme Checklist was used to critique and synthesise the findings. A total of five articles met the inclusion criteria, although most focused on healthcare professionals in general and looked at wider harassment and violence, rather than sexual harassment alone. The main factors that influenced the reporting of harassment were the normalisation of inappropriate behaviour, fear of reprisal and lack of clarity around policies and procedures. Further research is needed into the factors influencing the reporting of sexual harassment specifically in order to develop standardised reporting procedures and training programmes to prevent these incidents, and handle them appropriately when they do occur.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43484921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anne Phillips highlights disparities in diabetes care across the UK, emphasising the need for community-focused services design and integrated working to reduce the impact on patients and NHS services.
Anne Phillips强调了英国各地糖尿病护理的差异，强调需要以社区为中心的服务设计和综合工作，以减少对患者和NHS服务的影响。
{"title":"Delivering community-focused diabetes care to tackle health inequalities","authors":"A. Phillips","doi":"10.12968/bjhc.2023.0045","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0045","url":null,"abstract":"Anne Phillips highlights disparities in diabetes care across the UK, emphasising the need for community-focused services design and integrated working to reduce the impact on patients and NHS services.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47960408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The case for more NHS funding: the inconsistent triad","authors":"S. Bojakowski","doi":"10.12968/bjhc.2023.0056","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0056","url":null,"abstract":"","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49133764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emotional intelligence may help nurse managers to deal with conflicts. However, the relationship between emotional intelligence and conflict resolution is still not clearly understood. This study aimed to explore nurse managers' emotional intelligence levels and conflict resolution styles, and to identify any associations between these factors. A cross-sectional study design was used, with a convenience sample of 197 nurse managers recruited from five public and two university hospitals. Data were collected on emotional intelligence and conflict resolution using two specialised self-reported scale-based questionnaires. The Statistical Package for Social Sciences (version 25) was used to analyse data, with P<0.05 indicating statistical significance. The nurse mangers' average emotional intelligence scores ranged from 80–139 and 40% had low levels of work-related emotional intelligence. The integrating style was the most commonly used approach to conflict resolution, while the avoiding style was the least used. Higher levels of emotional intelligence were significantly associated with integrating, obliging and compromising styles, and were able to predict the use of integrating and compromising styles of conflict resolution. Nurse managers with higher levels of emotional intelligence are more likely to use the integrating and compromising styles of conflict resolution. Training programmes aiming to improve managers' conflict resolution skills should focus on assessing and increasing emotional intelligence.
{"title":"Emotional intelligence and conflict resolution styles among nurse managers: a cross-sectional study","authors":"Mohammad Dar Assi, N. Eshah","doi":"10.12968/bjhc.2021.0108","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0108","url":null,"abstract":"Emotional intelligence may help nurse managers to deal with conflicts. However, the relationship between emotional intelligence and conflict resolution is still not clearly understood. This study aimed to explore nurse managers' emotional intelligence levels and conflict resolution styles, and to identify any associations between these factors. A cross-sectional study design was used, with a convenience sample of 197 nurse managers recruited from five public and two university hospitals. Data were collected on emotional intelligence and conflict resolution using two specialised self-reported scale-based questionnaires. The Statistical Package for Social Sciences (version 25) was used to analyse data, with P<0.05 indicating statistical significance. The nurse mangers' average emotional intelligence scores ranged from 80–139 and 40% had low levels of work-related emotional intelligence. The integrating style was the most commonly used approach to conflict resolution, while the avoiding style was the least used. Higher levels of emotional intelligence were significantly associated with integrating, obliging and compromising styles, and were able to predict the use of integrating and compromising styles of conflict resolution. Nurse managers with higher levels of emotional intelligence are more likely to use the integrating and compromising styles of conflict resolution. Training programmes aiming to improve managers' conflict resolution skills should focus on assessing and increasing emotional intelligence.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49156169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Colleagues from the UK charity Action For M.E. discuss the overlap between long COVID and myalgic encephalomyelitis, and the implications of this for research into, and management of, these conditions.
{"title":"Long COVID and myalgic encephalomyelitis: opportunities for understanding and research","authors":"W. Strain, Shane Davies, Sonya Chowdhury","doi":"10.12968/bjhc.2023.0034","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0034","url":null,"abstract":"Colleagues from the UK charity Action For M.E. discuss the overlap between long COVID and myalgic encephalomyelitis, and the implications of this for research into, and management of, these conditions.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46032779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammed I Al Bazroun, Faiza Aljarameez, Roqaya Alhamza, G. Ahmed, Fatimah Alhybah, Abbas Al Mutair
High staff turnover among nurses can be caused by a variety of factors, including job dissatisfaction. This study aimed to assess factors influencing job satisfaction and retention among intensive care nurses in three tertiary care hospitals in Saudi Arabia. A multi-centre comparative cross-sectional study was carried out with 326 intensive care nurses working across three hospitals in Saudi Arabia. The Minnesota satisfaction questionnaire and the anticipated turnover scale were used to assess nurses' job satisfaction levels and intention to leave their organisation, with items scored on a 7-point Likert scale. Respondents' sociodemographic characteristics were also collected, including age, sex, nationality, salary, years of experience and shift length. Responses were analysed using the Statistical Package for Social Sciences version 25 to identify relationships between variables, with P values of ≤0.05 being considered statistically significant. Job satisfaction levels were generally low, with an average score of 58.34 out of 140. There was a significant inverse relationship between job satisfaction and intention to leave (P=0.001). Nurses who were not of Saudi Arabian nationality and those who earned less than 10,000 Saudi riyals had significantly higher levels of job satisfaction than Saudi Arabian nationals and those on higher salaries (P=0.001 and P=0.002 respectively). Other sociodemographic variables were not significantly associated with job satisfaction. Job satisfaction needs to be improved among nurses working in intensive care units to prevent high staff turnover rates. Understanding how sociodemographic variables can affect job satisfaction may help healthcare managers and policymakers to implement effective, targeted strategies to improve staff retention.
{"title":"Factors influencing job satisfaction and anticipated turnover among intensive care nurses in Saudi Arabia","authors":"Mohammed I Al Bazroun, Faiza Aljarameez, Roqaya Alhamza, G. Ahmed, Fatimah Alhybah, Abbas Al Mutair","doi":"10.12968/bjhc.2021.0146","DOIUrl":"https://doi.org/10.12968/bjhc.2021.0146","url":null,"abstract":"High staff turnover among nurses can be caused by a variety of factors, including job dissatisfaction. This study aimed to assess factors influencing job satisfaction and retention among intensive care nurses in three tertiary care hospitals in Saudi Arabia. A multi-centre comparative cross-sectional study was carried out with 326 intensive care nurses working across three hospitals in Saudi Arabia. The Minnesota satisfaction questionnaire and the anticipated turnover scale were used to assess nurses' job satisfaction levels and intention to leave their organisation, with items scored on a 7-point Likert scale. Respondents' sociodemographic characteristics were also collected, including age, sex, nationality, salary, years of experience and shift length. Responses were analysed using the Statistical Package for Social Sciences version 25 to identify relationships between variables, with P values of ≤0.05 being considered statistically significant. Job satisfaction levels were generally low, with an average score of 58.34 out of 140. There was a significant inverse relationship between job satisfaction and intention to leave (P=0.001). Nurses who were not of Saudi Arabian nationality and those who earned less than 10,000 Saudi riyals had significantly higher levels of job satisfaction than Saudi Arabian nationals and those on higher salaries (P=0.001 and P=0.002 respectively). Other sociodemographic variables were not significantly associated with job satisfaction. Job satisfaction needs to be improved among nurses working in intensive care units to prevent high staff turnover rates. Understanding how sociodemographic variables can affect job satisfaction may help healthcare managers and policymakers to implement effective, targeted strategies to improve staff retention.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48945311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
F. Frasquilho, K. Brittin, Auzewell Chitewe, M. Aurelio, Nicola Ballingall, R. Lloyd, Amar J. Shah
There has been an increase in the adoption of quality improvement methods to tackle complex problems in healthcare. One of the key requisites for sustainable quality improvement is ensuring that organisations have the capacity and capability to make these changes effectively. This article uses a case study methodology to describe the learning from 9 years of developing, delivering and evaluating quality improvement learning programmes at East London NHS Foundation Trust. The key quality improvement learning progammes are evaluated using a Kirkpatrick framework across four levels: reaction, learning, behaviour and outcomes. Five key principles were identified: using a dosing approach; standardising development, delivery and evaluation; developing a community to support learners; making training relevant; and the importance of leadership. However, the authors believe that more research is needed to develop standardised approaches to evaluating quality improvement capability building and to understand why some quality improvement projects are less successful than others.
{"title":"Building capacity and capability for quality improvement: developing an organisational approach","authors":"F. Frasquilho, K. Brittin, Auzewell Chitewe, M. Aurelio, Nicola Ballingall, R. Lloyd, Amar J. Shah","doi":"10.12968/bjhc.2023.0003","DOIUrl":"https://doi.org/10.12968/bjhc.2023.0003","url":null,"abstract":"There has been an increase in the adoption of quality improvement methods to tackle complex problems in healthcare. One of the key requisites for sustainable quality improvement is ensuring that organisations have the capacity and capability to make these changes effectively. This article uses a case study methodology to describe the learning from 9 years of developing, delivering and evaluating quality improvement learning programmes at East London NHS Foundation Trust. The key quality improvement learning progammes are evaluated using a Kirkpatrick framework across four levels: reaction, learning, behaviour and outcomes. Five key principles were identified: using a dosing approach; standardising development, delivery and evaluation; developing a community to support learners; making training relevant; and the importance of leadership. However, the authors believe that more research is needed to develop standardised approaches to evaluating quality improvement capability building and to understand why some quality improvement projects are less successful than others.","PeriodicalId":35342,"journal":{"name":"British Journal of Health Care Management","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42617299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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