Search

Purpose: This study aims to critically examine the effects of COVID-19 social discourses and policy decisions specifically on older adult volunteers in the UK, comparing the responses and their effects in England, Scotland, Wales and Northern Ireland, providing perspectives on effects of policy changes designed to reduce risk of infection as a result of COVID-19, specifically on volunteer involvement of and for older adults, and understand, from the perspectives of volunteer managers, how COVID-19 restrictions had impacted older people's volunteering and situating this within statutory public health policies. Design/methodology/approach: The study uses a critical discourse approach to explore, compare and contrast accounts of volunteering of and for older people in policy, and then compare the discourses within policy documents with the discourses in personal accounts of volunteering in health and social care settings in the four nations of the UK. This paper is co-produced in collaboration with co-authors who have direct experience with volunteer involvement responses and their impact on older people. Findings: The prevailing overall policy approach during the pandemic was that risk of morbidity and mortality to older people was too high to permit them to participate in volunteering activities. Disenfranchising of older people, as exemplified in volunteer involvement, was remarkably uniform across the four nations of the UK. However, the authors find that despite, rather than because of policy changes, older volunteers, as part of, or with the help of, volunteer involving organisations, are taking time to think and to reconsider their involvement and are renewing their volunteer involvement with associated health benefits. Research limitations/implications: Working with participants as co-authors helps to ensure the credibility of results in that there was agreement in the themes identified and the conclusions. A limitation of this study lies in the sampling method, as a convenience sample was used and there is only representation from one organisation in each of the four nations. Originality/value: The paper combines existing knowledge about volunteer involvement of and for older adults. [ABSTRACT FROM AUTHOR]

Purpose: As Covid-19 became a pandemic, numerous people were forced to stay at home, leading to increased intimate partner violence (IPV) in many countries, particularly in developing and least-developed ones. This paper aims to highlight the IPV based on 15 different cases formed from the practical evidence of five developing countries. Design/methodology/approach: The authors interviewed 15 women from five countries who were the victims of IPV during the early periods of Covid-19 outbreak. Due to geographical remoteness, the authors conducted informal telephone interviews to collect the participants' personal experiences. The conversations were recorded with participants' permission; afterwards, the authors summarized participants' experiences into 15 different cases without revealing their original identities (instead, disguised names were used). Findings: It was revealed that the women were the primary victims of such violence, particularly from their intimate partners (husbands). In most cases, such IPV, as reported by the interviewees, originated or increased after the pandemic when they were forced to stay at home, losing their partners' jobs or income sources. Originality/value: The authors summarized the causes of IPV and put forward a few action recommendations based on the interviewees' practical experience and existing literature. This paper will open a new window for research investigations on IPV during emergencies such as Covid-19 outbreak. [ABSTRACT FROM AUTHOR]

Purpose: The authors compare perspectives on external evaluation of health service provision between Norway and the USA. External inspection and accreditation are examples of internationally wide-spread external evaluation methods used to assess the quality of care given to patients. Different countries have different national policy strategies and arrangements set up to do these evaluations. Although there is growing attention to the impact and effects on quality and safety from external evaluation, there is still a gap in knowledge to how structures and processes influence these outcomes. Accordingly, the purpose of this article is to describe the structures and processes in external evaluation designed to promote quality improvement in Norway and the USA with attention to comparison of enablers and barriers in external evaluation systems. Design/methodology/approach: Data collection consisted of documentary evidence retrieved from governmental policies, and reviews of the Joint Commission (the US), international guidelines, recommendations and reports from the International Society for Quality in Health Care, and the World Health Organization, and policies and regulations related to Norwegian governmental bodies such as the Ministry of Health and Care Services, the Norwegian Directorate of Health, and the Norwegian Board of Health Supervision. Data were analyzed inspired by a deductive, direct content analytical framework. Findings: The authors found that both accreditation and inspection are strategies put in place to ensure that healthcare providers have adequate quality systems as well as contributing to the wider risk and safety enhancing management and implementation processes in the organizations subjected to evaluation. The US and the Norwegian external regulatory landscapes are complex and include several policymaking and governing institutions. The Norwegian regulatory framework for inspection has replaced an individual blame logic with a model which "blames" the system for inadequate quality and patient harm. This contrasts with the US accreditation system, which focuses on accreditation visits. Although findings indicate an ongoing turning point in accreditation, findings also demonstrate that involving patients and next of kin directly in adverse event inspections is a bigger part of a change in external inspection culture and methods than in processes of accreditation. Research limitations/implications: The message of this paper is important for policymakers, and bodies of inspection and accreditation because knowledge retrieved from the comparative document study may contribute to better understanding of the implications from the different system designs and in turn contribute to improving external evaluations. Originality/value: Although there is a growing attention to the impact and effects on quality and safety from external evaluation, the implications of different regulatory strategies and arrangements for evaluation on quality and safety remain unclear. [ABSTRACT FROM AUTHOR]

Purpose: Transitional care (TC) models emerged to ensure healthcare coordination and continuity, as at-risk patients transfer between different settings or different levels of care within the same setting. TC models have been developed in many countries as well as within different healthcare service delivery models and organizations. This paper aims to focus on a TC model developed in Italy called Operating Centre for Transition (OCT), in order to (1) explore its distinctive features by establishing a framework of analysis, (2) apply the framework to study two OCTs and (3) provide recommendations on how to use the framework to evaluate and develop new OCTs in the future. Design/methodology/approach: The authors adopted a grounded theory method to develop and validate the framework of analysis. The authors employed several qualitative methods following four iterative and recursive steps: (1) desk analysis of relevant documents, (2) in-depth interviews to key informants, (3) three meetings of an expert working group and (4) application of the framework to two case studies. Findings: The framework of analysis identifies three core dimensions that are always present in any OCT: the service model, the functions and the organizational features. Moreover, for every dimension several variables that capture and understand OCTs' nature, role and development level are identified. Originality/value: The results of the study highlight the key elements of the OCT model in Italy and show that the proposed framework can be useful both to analyse existing OCTs and to support health managers and policy makers to create new OCTs or develop those already active. [ABSTRACT FROM AUTHOR]

Purpose: In this article, we outline our views on the appropriateness and utility of Return on Investment (ROI) for the evaluation of the value of healthcare quality improvement (QI) programmes. Design/methodology/approach: Our recent research explored the ROI concept and became the genesis of our viewpoint. We reflect on our findings from an extensive research project on the concept of ROI, involving a multidisciplinary global systematic literature review, a qualitative and Delphi study with mental healthcare leaders from the United Kingdom National Health Service. Research participants included board members, clinical directors and QI leaders. Our findings led to our conclusions and interpretation of ROI against the broad QI governance. We discuss our views against the predominant governance frameworks and wider literature. Findings: ROI is in-line with top-down control governance frameworks based in politics and economics. However, there is evidence that to be of better utility, a tool for the assessment of the value of QI benefits must include comprehensive benefits that reflect broad monetary and non-monetary benefits. This is in-line with bottom-up and collaborative governance approaches. ROI has several challenges that may limit it as a QI governance tool. This is supported by wider literature on ROI, QI as well as modern governance theories and models. As such, we question whether ROI is the appropriate tool for QI governance. A more pragmatic governance framework that accommodates various healthcare objectives is advised. Practical implications: This article highlights some of the challenges in adopting ROI as a QI governance tool. We signal a need for the exploration of a suitable QI governance approach. Particularly, are healthcare leaders to be perceived as "agents", "stewards" or both. The evidence from our research and wider literature indicates that both are crucial. Better QI governance through an appropriate value assessment tool could improve clarity on QI value, and thus investment allocation decision-making. Constructive discussion about the utility and appropriateness of ROI in the evaluation of healthcare QI programmes may help safeguard investment in effective and efficient health systems. Originality/value: The article raises awareness of QI governance and encourages discussions about the challenges of using ROI as a tool for healthcare QI governance. [ABSTRACT FROM AUTHOR]

Purpose: Following the introduction of user fee for interpreting in Danish health care, a considerable decrease in interpreter services has been shown. This study aims to explore the experiences of language minority patients with health-care encounters when an interpreter was needed but not present. Design/methodology/approach: Semistructured, in-depth interviews were conducted with 13 language minority patients with limited Danish proficiency. All interviews were conducted with interpreters in the participants' native language. Data were analyzed using an inductive thematic approach. Findings: Most participants experienced communication difficulties and difficulties participating actively in their own health care. The experience of unresolved language barriers led to a high degree of uncertainty and left the participants with unanswered health concerns. Participants expressed a reluctance to seek health care, which consequently limited the utilization of health care services. Research limitations/implications: Although the findings only represent a small sample of patients, the results still reveal major challenges that minority-language patients encounter when seeking health care. Future studies should explore, if the intention of the law is met through the user fees. Practical implications: Despite having the same entitlements as native Danish-speaking patients, minority-language patients experienced difficulties accessing and using health care services due to the user fee and unresolved language barriers. The study elucidates patient perspectives and points to important ways of improving the quality of health care. Originality/value: To the best of the authors' knowledge, no investigation into the communicative consequences of the introduction of the user fee for interpreting services exists. Thus, this study seeks to address that gap. [ABSTRACT FROM AUTHOR]

Purpose: This review aims to examine the literature on refugees' and asylum seekers' resilience, its historical evolution, key principles, assumptions and recommendations, while focusing on the Canadian context. Design/methodology/approach: A narrative literature review has been applied to this manuscript. This approach allows the integration of a wide scope of literature and perspectives, from academic literature to grey literature (e.g. governmental reports and dissertations). Nevertheless, the limitations of this type of review were also discussed. Findings: In spite of the gaining popularity of the resilience lens, which emphasizes an individual's ability to overcome adversities and stressful events, more work is required for its effective integration into health practice, programs and policies, particularly as it relates to refugees' and asylum seekers' mental health care. Originality/value: Careful consideration of refugees' and asylum seekers' mental health needs and Canadian mental health service delivery and policies is a critical first step in reaching such a goal. [ABSTRACT FROM AUTHOR]

Purpose: This study aims to establish the perspectives of community providers on challenges and enablers in developing child mental health capacity in disadvantaged communities in South Africa. Design/methodology/approach: The authors involved 29 community providers operating in a large urban-deprived area in the Gauteng Province, east of Johannesburg. Community providers had educational, social and health care backgrounds. Their perspectives were captured through three focus groups, two participatory workshops and reflective diaries. Data were integrated and subjected to inductive thematic analysis. Findings: Three interlinked themes were identified. Community mobilization was viewed as pre-requisite through mental health awareness and strategies to engage children, youth and parents. Service provision should take into consideration contextual factors, predominantly inequalities, lack of basic needs and gender-based issues (domestic violence, teenage pregnancy and single motherhood). Participants referred to severe mental health needs, and related to physical health conditions, disabilities and impairments, rather than to common mental health problems or wellbeing. They proposed that capacity building should tap into existing resources and integrate with support systems through collaborative working. Practical implications: Child mental health policy and service design in Majority World Countries (MWCs), should involve all informal and structural support systems and stakeholders. Contextual factors require consideration, especially in disadvantaged communities and low-resource settings, and should be addressed through joined up working. Originality/value: Children's mental health needs are largely unmet in MWC-disadvantaged communities. These findings capture the experiences and perspectives of various community providers on how to enhance mental health provision by mobilizing communities and resources. [ABSTRACT FROM AUTHOR]

Purpose: The article aims to critically examine India's COVID-19 vaccination policy by analyzing the problem, politics and policy developed during the pandemic. The article would help the policy-makers and healthcare administrators to understand the situation in a holistic manner. Design/methodology/approach: The article employs Kingdon's multiple streams framework, which separately analyzes the problem at hand, the politics that are at work and the policy which is being developed when the problem and politics streams are activated. Directed approach to content analysis is adopted in this article. Findings: The article provides a holistic overview of vaccine development and the vaccination policy during the COVID-19 pandemic in India. Practical implications: The analysis would help policy-makers and healthcare administrators to have a bird's-eye view of the COVID-19 vaccine development and the vaccination drive. Originality/value: The article is a macro-level analysis of an extremely important situation of COVID-19 vaccine development and the subsequent vaccination drive for the world's largest democracy, which is also one of the largest drugs and vaccine manufacturing countries. The article captures the bird's-eye-view of the problem of vaccine development, the policy of funding as well as procurement, and the politics of vaccine distribution in the country. [ABSTRACT FROM AUTHOR]

Purpose: In this viewpoint article, the authors consider the challenges in implementing restrictive policies, with a particular focus on how these policies are experienced, in practice, from alternative standpoints.Design/methodology/approach: The authors draw on social science studies of decommissioning work to highlight how patient and official versions of value often vary, creating difficulties and distrust as restrictive policies are implemented. Patients and the public are well aware that financial calculations are somehow embedded in concepts of "evidence" and "value" but are usually unfamiliar with the social infrastructures that produce and utilise such concepts. The authors discuss with reference to a contemporary restrictive programme in England.Findings: While policymakers and researchers frequently present restrictive policies as "win-win" scenarios (achieving both cost-savings for healthcare services and improved patient care), social science analyses highlight the potential for tensions and controversies between stakeholders. The authors recognise that cost containment is a necessary component of policymaking work but argue that policymakers and researchers should seek to map (and make visible) the socially organised reasoning, systems and processes that are involved in enacting restrictive policies. Although transparency may pose challenges, it is important for informed democratic engagement, allowing legitimate scrutiny of whose voices are being heard and interests served (the "winners" and "losers").Originality/value: The authors argue for social science analyses that explore overuse, value and restrictive practices from alternative (e.g. patient) standpoints. These can provide important insights to help identify priorities for intervention and support better communication. [ABSTRACT FROM AUTHOR]