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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Dalal Alrubaishi, Helen Haugh, Paul Robson, Rachel Doern and William J. Wales
This study investigates the impact of socioemotional wealth (SEW) on family firm entrepreneurial orientation (EO) in Saudi Arabia, and the moderating effect of generational…
Abstract
This study investigates the impact of socioemotional wealth (SEW) on family firm entrepreneurial orientation (EO) in Saudi Arabia, and the moderating effect of generational involvement on this relationship. Our data set comprises 241 privately, wholly owned family firms. We examine EO as a strategic orientation expressed in terms of both firm behavior and how managers approach risk-taking attitudinally. Our study finds that SEW is positively related to firms’ entrepreneurial behavior, but not managerial attitudes toward risk-taking. However, the positive effects of SEW on firms’ entrepreneurial behavior diminish as the number of generations involved in the family business increases. The broader implications for enabling entrepreneurship within Arab transforming economies adhering to strong cultural tribalistic norms are discussed.
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Diane Cárdenas Elliott and Meghan W. Brenneman
The underrepresentation of men of color (MOC) in US higher education and the growing disparities in their educational attainment has prompted much concern among policy makers and…
Abstract
The underrepresentation of men of color (MOC) in US higher education and the growing disparities in their educational attainment has prompted much concern among policy makers and educators. The objective of this chapter is to address the comparative perspectives on equity and inclusion aim of the book by exploring why MOC are less like to earn a degree. We begin with a review of the contemporary literature on MOC and their academic transition to college in the United States. Next, findings from a longitudinal study that explored the early transitional challenges experienced by this population are presented. Results show the stark differences between high school and college in terms of faculty expectations, autonomous responsibility for academic coursework, and academic demands permeated early academic experiences of a group of MOC. Implications for practitioners are discussed.
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This chapter covers two behaviors that greatly affect college students’ mental health and wellbeing: eating and sleeping. The chapter begins with a definition of eating disorders…
Abstract
This chapter covers two behaviors that greatly affect college students’ mental health and wellbeing: eating and sleeping. The chapter begins with a definition of eating disorders and distinguishes clinically disordered eating from other forms of problematic eating. The chapter describes common eating disorders among college students: anorexia nervosa, bulimia nervosa, avoidant restrictive food intake disorder (ARFID) and binge eating disorder. The chapter then discusses measures of problematic eating among college students, including the SCOFF, the Eating Disorder Inventory and the Eating Concerns subscale of the Counseling Center Assessment of Psychological Symptoms (CCAPS). Next, the chapter discusses the prevalence of problematic eating among college students. Cultural considerations are described, with particular attention paid to gender, sexual orientation and ethnicity. Causes of problematic eating among college students are discussed, and the consequences of problematic eating are explored, from shame to medical complications to death. Treatment options are detailed, as are barriers to seeking professional help. The chapter follows a similar structure in covering healthy and problematic sleep behaviors among college students. In particular, the chapter explores measures of sleep quality, the prevalence of problematic sleep among college students, their causes and consequences, as well as strategies for correcting poor sleep and interventions for promoting healthy sleep habits.
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Patrick Parnaby and Ryan Broll
Most research on trauma, resilience and well-being among police officers focusses on those still on active duty. Comparatively speaking, and despite an aging workforce and…
Abstract
Purpose
Most research on trauma, resilience and well-being among police officers focusses on those still on active duty. Comparatively speaking, and despite an aging workforce and established negative health outcomes, similar inquiries involving police retirees are not as common. The purpose of this paper is to examine the effects of on- and off-the-job trauma and resilience on satisfaction with life among a sample of retired police officers.
Design/methodology/approach
Data were collected via a cross-sectional nonprobability electronic survey of police retirees in Ontario, Canada. While controlling for employment-related variables and demographic characteristics, a series of hierarchical multiple regression models were used to examine the effects of on- and off-the-job trauma and resilience on satisfaction with life among a sample of 932 participants.
Findings
The analysis indicates that off-the-job trauma and both personal and social dimensions of resilience contribute uniquely to satisfaction with life among police retirees. Moreover, this full model explains nearly 37% of the variance in satisfaction with life.
Originality/value
This study's findings offer further direction to those working to support the health and well-being of officers currently on the job and those well into their retirement years.
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ELSEWHERE in this number we list libraries which have Esent us copies of their annual reports which we are glad to have. Now and again we are able to elaborate on these, but in…
Abstract
ELSEWHERE in this number we list libraries which have Esent us copies of their annual reports which we are glad to have. Now and again we are able to elaborate on these, but in the present issue that has not been possible. We would say, however, that these reports are deserving of the attention of librarians generally, and of students at the library schools. They are records of work in progress, and they do suggest the development of library policy. The best of them are of textbook value.