Annie K. Lewis, Nicholas F. Taylor, Patrick W. Carney and Katherine E. Harding
Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of…
Abstract
Purpose
Interventions that improve timely access to outpatient health services are essential in managing demand. This process evaluation aimed to describe the implementation, mechanism of impact and context of an intervention to reduce waiting for first appointments in an outpatient epilepsy clinic.
Design/methodology/approach
The UK Medical Research Council framework was used as the theoretical basis for a process evaluation alongside an intervention trial. The intervention, Specific Timely Appointments for Triage (STAT), is a data-driven approach that combines a one-off backlog reduction strategy with methods to balance supply and demand. A mixed methods process evaluation synthesised routinely collected quantitative and qualitative data, which were mapped to the domains of implementation, mechanisms of impact and contextual elements.
Findings
The principles of the STAT model were implemented as intended without adaptation. The STAT model reached all patients referred, including long waiters and was likely generalisable to other medical outpatient clinics. Mechanisms of impact were increased clinic capacity and elimination of unwanted variation. Contextual elements included the complexity of healthcare systems and the two-tier triage practice that contributes to prolonged waiting for patients classified as non-urgent.
Originality/value
This process evaluation shows how a data-driven strategy was applied in a medical outpatient setting to manage demand. Improving patient flow by reducing waiting in non-urgent, outpatient care is a complex problem. Understanding how and why interventions work is important for improved timeliness of care, and sustainability of public health services.
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Annie K. Lewis, Nicholas F. Taylor, Patrick W. Carney and Katherine E. Harding
Long waitlists in outpatient clinics are a widely recognised problem. The purpose of this paper is to describe and report the impact of a waitlist reduction strategy for an…
Abstract
Purpose
Long waitlists in outpatient clinics are a widely recognised problem. The purpose of this paper is to describe and report the impact of a waitlist reduction strategy for an epilepsy clinic.
Design/methodology/approach
This observational study described the local impact of a methodical approach to tackling a long waiting list, using targeted strategies supported by a modest additional budget. The interventions were described using the template for intervention description and replication (TIDieR).
Findings
Over an eight-month period, the waitlist for the epilepsy clinic was reduced from 599 to 24 patients without increasing the number of days until the next available appointment. Most referrals were removed from the waitlist without an appointment. Auditing revealed a high proportion of patients no longer required the service or referrals remained on the waitlist due to administration error. A short-term increase in clinic capacity of 51 extra appointments met the needs of the remaining waiting patients. The additional project funding invested in this process was AUD $10,500 and a time-limited amount of extra work was absorbed by using existing clinic resources.
Practical implications
This waitlist reduction strategy resulted in a very small waitlist for the epilepsy clinic, which is now well placed to trial further interventions with the aim of sustaining the service with minimal waiting times. Not every referral on the waitlist, particularly the very long waiters, required an appointment. Other outpatient clinics may be able to apply this process to reduce their waitlists using a modest budget.
Originality/value
Although there are reports of successful waitlist reduction, few report the intervention in detail. Use of the TIDieR in reporting enables the intervention to be appraised or adapted to other settings where long waitlists are problematic. Considerations related to implementation of policy are discussed and in this case, a locally led and executed change management strategy was a key to achieving the result.
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Bob Gates, Colin Griffiths, Paul Keenan, Sandra Fleming, Carmel Doyle, Helen L. Atherton, Su McAnelly, Michelle Cleary and Paul Sutton
We issue a double Souvenir number of The Library World in connection with the Library Association Conference at Birmingham, in which we have pleasure in including a special…
Abstract
We issue a double Souvenir number of The Library World in connection with the Library Association Conference at Birmingham, in which we have pleasure in including a special article, “Libraries in Birmingham,” by Mr. Walter Powell, Chief Librarian of Birmingham Public Libraries. He has endeavoured to combine in it the subject of Special Library collections, and libraries other than the Municipal Libraries in the City. Another article entitled “Some Memories of Birmingham” is by Mr. Richard W. Mould, Chief Librarian and Curator of Southwark Public Libraries and Cuming Museum. We understand that a very full programme has been arranged for the Conference, and we have already published such details as are now available in our July number.
Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are…
Abstract
Communications regarding this column should be addressed to Mrs. Cheney, Peabody Library School, Nashville, Tenn. 37203. Mrs. Cheney does not sell the books listed here. They are available through normal trade sources. Mrs. Cheney, being a member of the editorial board of Pierian Press, will not review Pierian Press reference books in this column. Descriptions of Pierian Press reference books will be included elsewhere in this publication.
Elizabeth Ries, Erica Steinitz Holyoke, Heather Dunham, Murphy K. Young, Melissa Mosley Wetzel, Criselda Garcia, Katherina Payne, Annie Garrison Wilhelm, Veronica L. Estrada, Alycia Maurer and Katie Trautman
There is an urgent need for teacher preparation programs to equip teachers to teach in innovative and transformative ways, meeting the needs of diverse learners. Coaching is an…
Abstract
Purpose
There is an urgent need for teacher preparation programs to equip teachers to teach in innovative and transformative ways, meeting the needs of diverse learners. Coaching is an instrumental tool for supporting change and development, especially in contexts with decentralized teacher preparation guidelines.
Design/methodology/approach
This multicase study examines cross-institutional programmatic innovations for coaching teacher candidates (TCs) and centering equity using improvement science and equity coaching. The authors explore the networked improvement community’s (NIC’s) examination of problems of practice through plan–do–study–act cycles in three coaching contexts within and across seven institutions.
Findings
Qualitative methods revealed that adapting coaching protocols can center equity and build equity-focused practices. This work highlights revisions to coaching within and across teacher preparation programs (TPPs), which the authors hope inspires extending equity-centered coaching and improvement science to new contexts. This cross-case analysis revealed program innovations for coaches, digital technologies and alignment.
Practical implications
This study addresses ongoing challenges faced by TPPs in the United States, including TCs' understandings of equity in teaching and decentralized teacher preparation that results in varied and incongruent understandings about quality teaching. This study builds on previous scholarship that examines shifts in coaching practices by disrupting silos in TPPs as examined innovations.
Originality/value
The paper offers a unique view of cross-institutional collaboration in coaching to improve transformative teaching experiences in teacher preparation field experiences.
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The school-to-prison pipeline is a term used to describe the pathway traveled by students from public schools to incarceration in secure juvenile detention and correctional…
Abstract
The school-to-prison pipeline is a term used to describe the pathway traveled by students from public schools to incarceration in secure juvenile detention and correctional programs. It begins with students who are marginalized by the education system because of their academic and behavioral issues. The pipeline leads from school failure and disciplinary exclusion to involvement with the juvenile justice system. Youth who are ethnic minorities (especially those who are African-American or Hispanic) as well as those with educational disabilities (especially those with learning and behavioral disorders) are significantly overrepresented in data sets representing key points along the pipeline (e.g., students with poor academic achievement, high rates of suspension, expulsion, and dropout) as well as their high rates of incarceration. From his personal perspective and experience with the juvenile justice system, the author attempts to explicate the pipeline, and to describe efforts to impact it positively.
Robyn E. Metcalfe, Claudia Reino, Arriell Jackson, Jean M. Kjellstrand and J. Mark Eddy
Over 2 million individuals are incarcerated in the US criminal justice system. More than half of incarcerated Americans are also parents of minors. Parental incarceration can lead…
Abstract
Over 2 million individuals are incarcerated in the US criminal justice system. More than half of incarcerated Americans are also parents of minors. Parental incarceration can lead to a higher risk of mental illness and enduring trauma in children, as well as other problematic cognitive, developmental, and educational outcomes. Examining parental incarceration through a racial equity lens is critical, as people of color make up 67% of the incarcerated population despite making up only 37% of the US population. Further, gender-related equity issues pose important challenges for families with incarcerated parents. Here, we discuss prison-based psychosocial interventions designed both to build parenting skills and to improve parent well-being within a racial and gender equity lens. We hypothesize that effective services in these areas are essential components in a broad strategy designed to mitigate the potential negative effects suffered by families and children of incarcerated parents of color as a result of their imprisonment.
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MR. ALLAN BARNS‐GRAHAM, of Craigallian, Milngavie, has sent us a copy of a letter, addressed by him to the Secretary of the Scottish Agricultural Organisation Society and printed…
Abstract
MR. ALLAN BARNS‐GRAHAM, of Craigallian, Milngavie, has sent us a copy of a letter, addressed by him to the Secretary of the Scottish Agricultural Organisation Society and printed in pamphlet form, which contains a number of points of considerable importance. MR. BARNS‐GRAHAM observes that Bran and “Thirds” play a most important part in the rearing and feeding of cattle, pigs, and poultry, and in the production of milk; that these two products ought to be used to a much greater extent than they are now; that large quantities are annually exported from this country; and that the supplies ought to be jealously guarded. He expresses the hope that the Agricultural Organisation Societies of Great Britain and Ireland will in no way encourage the manufacture of condensed milk—on the ground that it is not in the interest of the public health, nor in the interest of agriculture to encourage the manufacture of any article of food which can be made to keep indefinitely by artificial means. This appears to us to be a somewhat strange position to take up, unless the author's intention is to condemn the practice of keeping food products by means of chemical preservatives—in which case we agree with him. But the proper preservation of many food products by legitimate and harmless methods, not involving the use of chemicals or of other objectionable devices, is surely permissible and valuable to the community. Properly prepared and sterilised condensed milk is a very useful commodity if it is what it purports to be. In this connection we may say, however, that condensed milk containing large quantities of added sugar ought not to be sold as “condensed milk,” but as “condensed sweetened milk,” or “condensed milk and sugar”—the proportion of added sugar being prominently disclosed; while, in our view, the sale of “condensed sweetened; ‘separated,’ or ‘machine‐skimmed’ milk” ought to be prohibited altogether.