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Biomedical subjects

A Laing

Publications and source records attributed to A Laing.

10 recordsLinked to original sources

Healthcare and the information revolution: re-configuring the healthcare service encounter.

Utilisation of internet-derived information by patients within the healthcare service encounter is increasing. Encompassing both the use of unidirectional information sites as well as bidirectional computer-mediated communities, this is manifest in the growth of consumerist expectations on the part of patients. Based on interviews with patients, professionals and internet site managers, this paper examines the role of the internet as a source of patient information and support, and in particular the effect on the relationship between 'informed' consumers and professionals involved in the delivery of healthcare services. The core challenge for informed consumers is to develop frameworks that facilitate robust dialogue, exchange of information and emotional support to complement their rising authority. The parallel challenge is for the established medical profession to recognize the consequences of this evolving dialogue and develop approaches to service delivery that effectively engage with consumers on the basis of this increasing authority.

Health Personnel↗

Administration to innovation: the evolving management challenge in primary care.

The concept of the primary health-care team involving an increasingly diverse range of health care professionals is widely recognized as central to the pursuit of a primary care-led health service in the UK. Although GPs are formally recognized as the team leaders, there is little by way of policy prescription as to how team roles and relationships should be developed, or evidence as to how their roles have in fact evolved. Thus the notion of the primary health-care team while commonly employed, is in reality lacking definition with the current contribution of practice managers to the operation of this team being poorly understood. Focusing on the career backgrounds of practice managers, their range of responsibilities, and their involvement in innovation in general practice, presents a preliminary account of a chief scientist office-funded project examining the role being played by practice managers in primary health-care innovation. More specifically, utilizing data gained from the ongoing study, contextualizes the role played by practice managers in the primary health-care team. By exploring the business environment surrounding the NHS general practice, the research seeks to understand the evolving world of the practice manager. Drawing on questionnaire data, reinforced by qualitative data from the current interview phase, describes the role played by practice managers in differing practice contexts. This facilitates a discussion of a set of ideal type general practice organizational and managerial structures. Discusses the relationships and skills required by practice managers in each of these organizational types with reference to data gathered to date in the research.

Community Health Services↗

Partnerships in purchasing: development of consortium-based purchasing among GP fundholders.

In the last few years there have been considerable changes in the National Health Service (NHS) in the UK. Arguably the most significant of these has been the introduction of competition. Central to this development has been the introduction of general practice (GP) fundholding, whereby practices purchase health care for their patients directly from competing suppliers. Those practices which have become fundholders have faced considerable challenges in developing their purchasing function, given the complexities of contracting within the context of the NHS internal market. Although one of the original aims of GP fundholding was to facilitate locally responsive purchasing, such have been the complexities of contracting that many fundholding practices have attempted to reduce the managerial demands of purchasing through membership of purchasing consortia. Based on an in-depth study of GP fundholders across Scotland, this paper explores the development of consortium-based purchasing. Specifically, this paper seeks to address three issues central to the evolution of such consortium-based purchasing. Firstly, the patterns of organizational structure and the operational dynamics of such consortia. Secondly, the impact of such consortia on the process of fundholder purchasing. Thirdly, the managerial implications of purchasing through such consortia for the participating practices. In addressing these issues, it will examine whether such patterns of purchaser development have impacted on the evolution of locally responsive purchasing.

Budgets↗

Ophthalmic pain following cataract surgery: a comparison between local and general anaesthesia.

Ophthalmic pain following uncomplicated extracapsular cataract surgery was assessed postoperatively in 61 patients; 55% undergoing ophthalmic surgery had no pain or discomfort postoperatively, and 32% reported slight discomfort. Approximately 8% of patients reported mild pain and the remaining 5% experienced moderate to severe pain. Local anaesthesia was shown to be more comfortable postoperatively than general anaesthesia in the immediate postoperative period with both groups receiving similar amounts of postoperative analgesics.

Acetaminophen↗

Minor surgery: an extended role for ophthalmic nurses in the United Kingdom.

This article discusses the reasons for extending the scope of ophthalmic nursing practice in the Princess Alexandra Eye Pavilion, Edinburgh, Scotland, particularly with regard to the ophthalmic nurses' role and management of meibomian cysts (chalazions) through minor surgery to the eyelid. The article describes how the in-service teaching program was established in the hospital for those ophthalmic nurses who were interested in developing their knowledge and practical surgical nursing skills to undertake the management of meibomian cysts. The appropriate legal and ethical aspects of patient care involved in extending the scope of practice in the United Kingdom are discussed, including accountability and duty of care.

Chalazion↗