Derek Milne, Dominique Keegan, Roger Paxton and Kaeti Seth
An interview‐based survey of evidence‐based practice (EBP) and the research, continuing professional development (CPD) and audit activity that support it was conducted in the…
Abstract
An interview‐based survey of evidence‐based practice (EBP) and the research, continuing professional development (CPD) and audit activity that support it was conducted in the North East of England amongst a representative sample of NHS clinical psychologists and counsellors (n = 30). It profiled their participation in EBP activities over the past year and their intentions for the next year. The findings suggest that the sample had used guidelines and protocols on 56 per cent of occasions, had on average drawn on research, CPD and audit approximately half of the time, but had been only minimally influenced by research, CPD or audit. It is concluded that EBP has occurred in all defined areas and that the conditions for an increased degree of EBP are promising.
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Derek Milne, Seirian Hanner, Katy Woodward and Colin Westerman
It is now recognised that therapists require career‐long training in order to maintain and improve their expertise. However, training will fail to improve services to clients…
Abstract
It is now recognised that therapists require career‐long training in order to maintain and improve their expertise. However, training will fail to improve services to clients unless the work environment supports staff in its use. Although this “training transfer” problem is widely acknowledged, to the authors' knowledge the way that the work environment influences clients' access to effective therapies has not been subjected to a detailed and systematic formulation. Therefore, this small study illustrates a suitable formulation, based on the training received by a group of National Health Service (NHS) staff in “psychosocial interventions”, and proposes its use as a “feedback fascia” to managers and others. To do this, structured interviews were held with a self‐selected sample of n=20 therapists (mostly nurses) and all of their managers (n=11) in one NHS Trust. The results indicated an impressive degree of training transfer. It is concluded that staff training can improve clients' access to effective treatments, but that significant organisational support for innovation is required. A feedback fascia can guide such support.
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Seeks to enhance the measurement of training; describes thedevelopment of psychometrically sound and practical measures to assessoutcomes relating to in‐service management…
Abstract
Seeks to enhance the measurement of training; describes the development of psychometrically sound and practical measures to assess outcomes relating to in‐service management training within a National Health Service District. Develops legitimate measurement tools and demonstrates the positive effects of two specific programmes in relation to behavioural change and participant satisfaction. Further work is required to establish how to monitor the effects of the action learning process in terms of cognitive development.
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Ten psychiatric day hospitals for elderly people were surveyed in the UK′s northern region to try and establish the extent to which nurses were implementing quality assurance…
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Ten psychiatric day hospitals for elderly people were surveyed in the UK′s northern region to try and establish the extent to which nurses were implementing quality assurance procedures. Based on a structured interview the results indicated that there was considerable implementation and success, including ready access to day services and high acceptability and effectiveness. Relatively little progress has been made in terms of evaluation, staff training and support. In general it is concluded that this small sample of psychiatric nurses has developed good practices in parallel with QA, rather than being guided or supported by the QA initiative. Implications are drawn for a more integrated approach to QA.
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Analysis and improvement of the quality of care has become everyone’s business in the new NHS. Audit of clinical outcomes and of patient satisfaction are to become routine…
Abstract
Analysis and improvement of the quality of care has become everyone’s business in the new NHS. Audit of clinical outcomes and of patient satisfaction are to become routine. However, there is a weak link between audit and service quality, reflecting an insufficient emphasis on the process of organisational innovation. This case study illustrates how “a first class service” can be developed through a “stakeholder‐collaborative” evaluation approach. This partnership process can strengthen the audit‐quality link, leading to practical and shared suggestions for service development. Clinical outcome data from 400 consecutive adult mental health patients seen over a five‐year period by one clinical psychologist and patient satisfaction data (for the last 100 patients) were evaluated by 11 stakeholders. They evaluated these data in relation to Maxwell’s six quality criteria. Both the clinical outcomes (i.e. highly significant improvements following therapy) and the patient satisfaction data were judged favourably by the stakeholders, who used the information to suggest service improvements.
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Derek Milne, Andrea McAnaney, Ben Pollinger, Katie Bateman and Emma Fewster
Voluntary organisations are an integral part of community care, and the available research indicates the value of their social support role. However, surprisingly little is known…
Abstract
Voluntary organisations are an integral part of community care, and the available research indicates the value of their social support role. However, surprisingly little is known about the forms and functions of this support, or the links to the formal support provided by the National Health Service (NHS), so hampering quality improvements. Therefore, a small sample of voluntary service organisations in one English county participated in a pilot study. This involved the staff and users of these organisations, and a geographically linked sample of NHS mental health professionals. Interview data indicated that the voluntary sector users and staff held similarly positive views of the appropriately varied forms and functions of the provided social support, and all participants held unusually similar and positive views of their links, although areas for improvement were suggested by both groups (e.g. links to GPs).
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Seeks to enhance the measurement of training; describes thedevelopment of psychometrically sound and practical measures to assessoutcomes relating to in‐service management…
Abstract
Seeks to enhance the measurement of training; describes the development of psychometrically sound and practical measures to assess outcomes relating to in‐service management training within a National Health Service District. Develops legitimate measurement tools and demonstrates the positive effects of two specific programmes in relation to behavioural change and participant satisfaction. Further work is required to establish how to monitor the effects of the action learning process in terms of cognitive development.
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Reports on a small‐scale quality assurance analysis of rural mentalhealth drop‐in centres. Within a cross‐sectional research design,measures were taken of the centres’ structure…
Abstract
Reports on a small‐scale quality assurance analysis of rural mental health drop‐in centres. Within a cross‐sectional research design, measures were taken of the centres’ structure, process and outcome. The instruments used to take these measures were structured interviews, questionnaires and direct observation, which were applied to clients, staff and referrers. It was found that the centres achieved their objectives with considerable success, including high levels of client and referrer satisfaction. Concludes that the three centres provided a quality service which complements the formal options (i.e. NHS and Social Services). Draws implications for the extension of NHS staff roles in relation to the voluntary sector.
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Derek Milne, Simon Eminson, Heather Wood, Lillian Hamilton and Kevin Gibson
Reports on a three‐month period of evaluation of changes in theperceived life stress, coping and strain of 60 consecutive new attendersat a community mental health centre, which…
Abstract
Reports on a three‐month period of evaluation of changes in the perceived life stress, coping and strain of 60 consecutive new attenders at a community mental health centre, which served to monitor performance. Emphasizes the need to incorporate good measurement into a systematic approach to quality assurance.
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Mark A. Papworth, Derek Milne and George Boak
Hersey and Blanchard's situational leadership (SL) model is widely utilised, but it has limited empirical support. This paper aims to investigate the model through content…
Abstract
Purpose
Hersey and Blanchard's situational leadership (SL) model is widely utilised, but it has limited empirical support. This paper aims to investigate the model through content analysis of the transcripts of supervision sessions.
Design/methodology/approach
Eight transcripts of successful supervision interviews are subjected to in‐depth content analysis to investigate the validity of aspects of the SL model, principally that successful leadership interactions would vary systematically according to the level of supervisee experience. The supervisees consist of a novice, four training therapists, and three post‐graduate therapist practitioners. Statistical analyses are undertaken to investigate fundamental, predicted differences between the speech behaviours associated with the different developmental levels of these supervisees.
Findings
The findings offer only partial support for the model. As predicted, an increased proportion of supervisor speech is observed in the supervision of increasingly less experienced therapists. However, the majority of the more specific speech behaviours associated with supervisee experience level are not in keeping with the model.
Originality/value
These results are consistent with the findings of other evaluations of the SL model. As the present results are based on a novel approach, this increases the plausibility of the claim that SL lacks adequate empirical support. Areas of development and exploration are recommended, and limits associated with the model's utility are highlighted.