Showing papers by "Rod Sheaff published in 2011"

Unplanned admissions of older people : exploring the issues

Abstract: 1 Personal Social Services Research Unit, London School of Economics and Political Science 2 Faculty of Health, University of Plymouth 3 Centre for Research in Primary & Community Care, University of Hertfordshire 4 Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University 5 Personal Social Services Research Unit, University of Kent 6 School of Nursing and Midwifery, Clinical Education Centre, Keele University

Improving emergency care pathways: an action research approach.

Abstract: Background Clinicians and managers across specialities are under pressure to review treatment and referral pathways to enable evidence-based practice, improve patient flow and provide a seamless service. This study outlines the processes and outcomes of an action research study conducted to reduce inappropriate attendances and unplanned pressures on Emergency Department (ED) staff in an English hospital during 2006–2008. Methods Action research, comprising three action/reflection cycles conducted with participants, was used. Data were collected using retrospective patient record review (n=35 200) interviews with staff members (n=28), observation of patient pathways (n=38 patients) and measurement of team climate (n=31) with literature reviews also informing each cycle of data collection. Results ED attendance and hospital emergency admission data were largely similar to the national picture with regards to time/day of attendance and seasonal variation. However, in the ‘adult majors’ subgroup, mean attendance on a Monday was significantly higher than the rest of the week (p Conclusions Study data suggest that inappropriate attendances decreased; however, data collection exposed gaps in the existing management information systems and inconsistencies in working practices in the ED. Action research can have a practical value besides contributing to knowledge.

Unplanned hospital admissions of older people: exploring the issues

Abstract: This study will look at the ways in which social services, hospitals and community health services work together to finance, organise and deliver services, and particularly how this affects the use of hospital services by people aged 75 or older. Finding the best ways for these organisations to work together would help to make sure that older people get the right services provided by the right people in the right place at the right time. Nine councils spread across England have been brought together as part of the government's Innovation Forum. They are aiming to reduce the number of days that older people spend in hospital by providing alternative services that are at least as good and which improve the lives of older people. Most people want to avoid going in to hospital or staying longer than is necessary, and many efforts are being made to develop alternative services. The councils in this study want to lower the total number of days that older people spend in hospital by 20% over a three year period. In each council the local Primary Care Trust(s) and the hospital trust(s) have agreed on this target and on ways to achieve it. The study will ask these questions: - What achievements have been made in lowering hospital bed use by older people? - How do health and social services staff - together with housing providers, charities and others - work together to run services that are alternatives to hospital care? - What changes have been made in these 9 areas so that they can have fewer emergency admissions to hospital? The research will take 2 years to complete and will include activities to ensure that people working in the health and social services are aware of the findings.