Search results

The Royal College of Surgeons recognises patient handover as the point at which patients are collectively at their most vulnerable. Concerns were raised in a London teaching hospital surgical department regarding an unstructured handover system, poor access to relevant clinical information, and inadequate weekend staffing. A quality improvement programme was designed and implemented to respond to these concerns and improve patient safety. The paper aims to discuss these issues.

A structured questionnaire was distributed to staff and results used to construct a diagram outlining the main factors influencing weekend patient safety. This framework was used to design changes, including a new electronic handover tool, regular handover meetings and additional weekend staff. Regular staff training was provided, and success was assessed in a continuous audit cycle with the results fed back to team leaders.

Over a three-month period, the handover meeting recorded an attendance rate consistently above 80 per cent. The electronic handover entries were scored according to seven criteria (correct layout; key information, i.e.: patient location, clinical priority, active issues, resuscitation status, test results and weekend plan), averaging between 42.2 and 92.9 per cent, with progressive improvement seen over the assessment period. Weekend staffing was increased by 50 per cent, allowing a dedicated team to care for stable inpatients and to oversee discharges.

This improvement programme delivered lasting and significant change in response to staff concerns. It resulted in a more structured and reliable weekend system and established key mechanisms for dynamic performance feedback.

Both authors have been involved as lay members in research and other activities for a number of years, ensuring they represent the views of members of the public. This chapter identifies what is, and what is not, patient and public involvement as well as highlighting the importance of involving members of the public in all aspects of the research process. Best practice is explored as identified in the UK Standards for Public Involvement 2019 and the UK Policy Framework for Health and Social Care Research 2020. The implications of the Mental Capacity Act and its wording on research matters are also considered. Case studies have been incorporated to highlight the impact of involving patients and members of the public in all aspects of the research process. These include the lessons learnt by researchers and lay members of the team. The aspiration is to move towards more collaboration between members of the public and researchers; therefore, we discuss co-production of research or community-based participatory research (CBPR). We highlight the need for a better partnership between researchers and members of the public. The benefits of this are explored along with the consequences for all involved.

This paper aims to understand employees’ propensity to blow the whistle in two East African countries. This study develops a model of ethical decision-making (EDM) to assist management in predicting the probability of whistleblowing in Kenya and Uganda. It also seeks to find the moderating effect of perceived retaliation on whistleblowing intention.

This study administers a standardized questionnaire to employees in Kenya and Uganda to measure their perceptions about whistleblowing in their organizations. This study uses partial least square structural equation modeling to test the hypotheses. This study uses four constructs, namely, awareness, judgment, retaliation and likelihood, of blowing the whistle. These constructs are measured with multiple-item scales.

The results show that ethical awareness and judgment significantly increase willingness to engage in whistleblowing in East Africa. However, this study does not find a significant retaliation effect on whistleblowing intention. Instead, this study finds that awareness and judgment mediate between retaliation and willingness to engage in whistleblowing.

This study contributes to EDM topics. It advances the understanding of the whistleblowing concept, the retaliation effect and the reasons to encourage blowing the whistle in Africa. However, this study did not consider cultural factors, such as nationality, patriotism and ethnicity. Moreover, the results are only based on data from Uganda and Kenya and may not apply to other sub-Saharan nations.

These findings are particularly significant for managers and policymakers in East Africa, where fear of retaliation and lack of awareness are the main barriers to whistleblowing. The results may help managers develop human resource practices to include policies to support moral behavior. It may also provide insights to the policymakers to understand the factors that facilitate whistleblowing practices and help them to adopt new strategies or policies to stimulate whistleblowing culture.

This study is one of the initial empirical studies in the East Africa context to explore the EDM predictors and the impact of retaliation on the whistleblowing intention.

This paper explores the health rights of prisoners as defined in international law, and the mechanisms that have been used to ensure the rights of persons in detention to realise the highest attainable standard of health. It examines this right as articulated within United Nations and regional human rights treaties, non‐binding or so‐called soft law instruments from international organisations and the jurisprudence of international human rights bodies. It explores the use of economic, social and cultural rights mechanisms, and those within civil and political rights, as they engage the right to health of prisoners, and identifies the minimum legal obligations of governments in order to remain compliant with human rights norms as defined within the international case law. In addressing these issues, this article adopts a holistic approach to the definition of the highest attainable standard of health. This includes a consideration of adequate standards of general medical care, including preventative health and mental health services. It also examines the question of environmental health, and those poor conditions of detention that may exacerbate health decline, disease transmission, mental illness or death. The paper examines the approach to prison health of the United Nations human rights system and its various monitoring bodies, as well as the regional human rights systems in Europe, Africa and the Americas. Based upon this analysis, the paper draws conclusions on the current fulfilment of the right to health of prisoners on an international scale, and proposes expanded mechanisms under the UN Convention against Torture and Other Cruel, Inhuman or Degrading Treatment to monitor and promote the health rights of prisoners at the international and domestic levels.

A survey of dental services for people with learning disabilities was undertaken as part of the Board's ongoing programme of service monitoring. The choice of topic was influenced by changes within dentistry regarding the administration of general anaesthetics, and by proposed changes in the patient population of Muckamore Abbey Hospital (North and West Belfast Health and Social Services Trust). Information was obtained primarily through questionnaires from people with learning disabilities who were living in the community and from general dental practitioners. Information was also sought from the three trusts providing a dental service in the area. The survey found that both patients with learning disability and dentists treating them would benefit from more specialist information and training.

This chapter reviews the literature to contextualize the intervention in the post–cold war era characterized by the momentum of globalization dominated by informal actors beside the legal authority of the state. It indicates how these actors deviate the primary purpose of the humanitarian intervention and create an ungovernable environment of the state particularly when interventions are operated in countries endowed with natural resources. The case of the Democratic Republic of the Congo (DRC) serves as a model to ascertain such phenomenon in which actors such as states involved in intervention come in collusion with shadow elites, lobbyists and multinational companies to establish clandestine networks of illegal exploitation and smuggling of natural resources. The chapter winds up by suggesting the redefinition of policies of interventions to keep humanitarian intervention in its primary mission while holding actors involved in illegal and smuggling of natural resources accountable.

This introduction chapter provides an overview of the key issues highlighted throughout this book. First, we tackle why it is problematic to only characterize Black children’s accomplishment in terms of the “academic achievement gap.” Second, we discuss the importance of the home-school environment connection. Finally, we discuss the changes that need to be made in terms of teacher preparation in order to ensure that the workforce can practice racial equity in the classroom. All these issues are woven together by a call for closing the education opportunity gap via “equity adjustments” that can target educational and health disparities facing the Black community.

Group‐based psycho‐educational interventions offer a cost‐effective solution to meeting the very high level of demand for psychological services in primary care. This qualitative study investigated reasons for dropout from an established psychoeducational course programme in Swindon and Wiltshire. Ninety people were followed up by telephone who had attended at least one session of a course over a three‐month period. Reasons stated for dropout were more often related to personal circumstances such as other commitments and ill health (75%), than to dissatisfaction with the courses (25%). It is concluded that providing group‐based interventions for common mental health problems is acceptable to patients in primary care and that service development should focus on making such interventions flexible and accessible to patients.