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Background: The Personalised Residential Supports (PRS) Project provided detailed information about the nature, purposes and outcomes of PRS from the perspectives of key stakeholder groups including people with developmental disabilities, family members and service providers. Although these forms of support have developed over the past two decades, there is a dearth of empirical work that has explored the characteristics of PRS. In contrast, there is a multitude of empirical studies on congregate forms of residential support with a clear trend towards study of the characteristics of relatively small, congregate residential settings. Methods: Personalised Residential Supports was conceived initially in the study as having four key criteria in the support arrangements--a high degree of: individualisation; individual/family influence; informal relationships; and, person-centredness. Four methods of data collection were used to develop a descriptive framework for PRS: a review of empirical and descriptive literature that met inclusion criteria; case studies carried out over 2 years of six adults whose living arrangements met the initial PRS criteria; a focus group of adults with developmental disabilities; and, a series of written surveys of 18 people who were "experts" in their experience and knowledge of PRS-type support arrangements. The latter group included family members, service providers and policymakers. Each dataset was analysed separately and independently by the authors and a third researcher, followed by a process of conciliation and consensus in which the quality framework was developed. Two iterations of the expert group surveys were used to fine tune the framework. Results: Qualitative analysis resulted in a PRS quality framework made up of nine themes containing 28 attributes. Descriptions of each theme and attribute are provided. The nine themes were named as: Assumptions, Leadership, My Home, One Person at a Time, Planning, Control, Support, Thriving and Social Inclusion. Conclusion: This study identified the characteristics of PRS as reported by key stakeholder groups. On face value, the themes expressed in the PRS framework have relevance to all forms of supported accommodation, for many different groups of people. The research is continuing by further development of the framework that will enable its use in the evaluation of existing or planned residential support arrangements.

Byline: N.C. Proudlove, R. Boaden This paper provides an analysis of information systems (IS) currently used in UK hospitals to support the effective management and utilisation of beds. It focuses particularly on IS working at the level of individual patients (particularly in real-time), rather than aggregate planning tools. It locates these systems within the broader context of the National Programme for IT (NPfIT) and concludes that such systems will continue to have an important place in improving bed utilisation while the NPfIT is being rolled out, and in some cases could contribute useful implementation experience and algorithms.

Background: The Individual Placement and Support (IPS) model aims to achieve open employment for people with mental illness. The Supported Employment Fidelity Scale (SEFS) is a 15-item instrument that evaluates the extent to which a service follows the IPS principles of best practice. This paper describes the IPS model and an evaluation of a specialist employment program for people with mental illness using the SEFS. Methods: The SEFS enabled a quantitative assessment of service provision against the criteria of evidence-based practice principles. Data were collected from multiple sources. In addition, a literature review was conducted, and personnel engaged in implementation of the IPS model at other Australian employment programs were consulted. Results: The program achieved a score of 59 of a possible 75 on the SEFS, which is described as fair supported employment. Discussion: Analysis of the 15-scale items resulted in the identification of strengths, areas for further development, and a set of recommendations. Conclusions: The program was operating substantially in line with evidence-based practice principles and had considerable scope for further development. Issues arising from the evaluation, areas of applicability of the SEFS and the underlying literature, and implications for occupational therapy are highlighted. [ABSTRACT FROM AUTHOR]

Aim To describe actual patient caseload sizes among case managers for long term conditions and explore issues of caseload manageability. Background Department of Health guidance advises that community matron case managers for long term conditions should manage caseloads of 50-80 patients. However, there is currently no evidence to justify these caseload targets. Method In-depth interviews were conducted with 46 case managers for long term conditions, five clinical leads and six programme leads across six Primary Care Trusts. Findings Case managers had caseloads of 10-55 patients each, although numbers fluctuated from week to week. The current caseload target was regarded as difficult to manage. Heavy caseloads were perceived to result in a shift from proactive care towards reactive care, decreased quality of care and increased hospital admissions. Conclusion Case managers for long term conditions are struggling to achieve and maintain caseload targets. Further research is necessary to identify the most appropriate caseload size and provide an evidence base for policy. Implications for nursing management Programme leads and managers need to carefully assess the local situation, the characteristics of the target population and the practicalities of delivering the model of care before identifying appropriate caseload targets. [ABSTRACT FROM AUTHOR]

Aim This paper describes and analyses the role of bed managers within hospitals, and how this can be supported through a development programme. Background and key issues Bed management has increased in importance as access targets have developed, and appreciation of the importance of patient flow has grown. The bed management role is usually performed by nurse managers, and can be particularly stressful and managerially complex. Despite calls for training support, little has been available. In response we have developed and delivered a training programme to over 70 staff in the past 2 years. Evaluation and conclusions The programme evaluation data is used to show that it has had an impact on the knowledge and skills of the bed managers involved, but also on their subsequent behaviours. These changes have translated into results for the organization and the individual, including staff retention, promotion and fewer cancelled operations. We conclude that the programme is an effective way to enhance the knowledge and skills of bed managers, and that the enhanced profile of bed management raises challenges for nurse managers in many areas of the organization. [ABSTRACT FROM AUTHOR]

This paper outlines the development of a method of planning for Computer-Integrated Manufacture (CIM) in a company manufacturing complex engineering products at a number of sites in Europe. The method described relies heavily on a model (i.e. a diagrammatic representation) of CIM as the for planning. A selection of different models is given alone with a critique of their usefulness in CIM planning, and a method by which such models can be classified. Some guidelines for developing a model of CIM are given along with the experiences of the company in planning for CIM. The main findings of the research indicate that the development of a CIM model is beneficial not only for planning; the process of evolution of the model can greatly increase understanding of CIM. Furthermore it helps to focus on functions and business objectives rather than being constrained by departmental boundaries, bringing a new dimension to strategic planning. [ABSTRACT FROM AUTHOR]

To date, relatively little has been written about computer-integrated manufacture (CIM), but what has emerged from such writings is a profusion of definitions and interpretations. This article reports on an attempt to categorise the various definitions of CIM. The findings of this analysis reveal that the most common definitions regard CIM as something which affects the whole organisation, by computerising the major organisational functions, or viewing the organisation as part of a total business unit. The other main definitions of CIM view it as an ‘integrated CAD/CAM system’, or a system which uses the most advanced manufacturing technology. Both these definitions, however, take a narrow view of CIM and do not take external influences into account. It is the authors' view that the most important part of CIM is integration, and this must encompass all areas of the business. [ABSTRACT FROM AUTHOR]