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PubMed2003

Increasing research impact through partnerships: evidence from outside health care.

There is growing interest in using closer partnerships between researchers and research users to increase the appropriate application of research evidence in policy and practice. While this supplement reports and assesses a number of these initiatives in health care, this article reviews the evidence in support of partnerships from elsewhere. Drawing on a substantial cross-sector review of research impact initiatives, we extract lessons for health care from partnership evaluations in social care, education and criminal justice services. A reasonable and robust evidence base supports the use of partnerships as one means of increasing research uptake. Although requiring substantial investments of time, resources and commitment, and suffering from a number of possible pitfalls, we conclude that such partnerships offer great potential for increasing research use.

Cooperative Behavior↗

PubMedDate not supplied

Enhanced undergraduate public health nursing experience: a collaborative experience with the Kentucky Department for Public Health.

The Kentucky Department for Public Health and the University of Kentucky College of Nursing entered into a collaborative partnership to provide an enhanced public health nursing experience for a select group of undergraduate students. The purpose of the project was to strengthen the public health nursing practices component of the baccalaureate nursing program in the College of Nursing at the University of Kentucky. The objectives of the project related to planning, implementing, and evaluating of this program in partnership with the Kentucky Cabinet for Health Services, State Health Department in Frankfort, Kentucky. The selected baccalaureate students were paired with a preceptor and a state, local, or district public health agency with an identified need in the student's area of interest. The students participated in a mentoring experience with a practicing public health nurse consultant. The experience afforded the students an opportunity to interact at both the practice and policy development levels. An ongoing partnership developed between the state health department, local health departments, and the college of nursing. This partnership led to ongoing practicum placements for students, beneficial for both the health departments and the college of nursing.

Community Health Services↗

PubMed1980

Out-of-hours visits in a group practice.

In one year 1644 out-of-hours calls were undertaken by a partnership of eight doctors working in a deprived inner urban area and a deprived large council housing estate; of these calls 332 were performed between the hours of 11 pm and 7 am. The number of calls required in the housing estate, 1077, was about twice as many as in the inner urban area, although the same doctors were using the same criteria for a visit. The rate of visits of 107 per 1000 patients in the housing estate was much higher than in other published series. The reasons for this difference appeared to be related to the comparative youth of parents and the number of young children.

Age Factors↗

PubMedDate not supplied

Preserving midwifery practice in a managed care environment.

Since 1925 when nurse-midwifery emerged as a new health profession in the United States, and over the past 30 years under the auspices of the American College of Nurse-Midwives (ACNM), national standards for education, certification, and practice have enabled nurse-midwives to provide the quality of care that is highly valued by policy-makers and consumers. This paper describes the education and practice of over 7,000 midwives who have received national certification through mechanisms developed by the ACNM, describes the strengths of the profession, and reviews the impact of managed care on the practice of midwifery. Also highlighted is ACNM's development of a partnership, with the Maternal and Child Health Bureau, to study the impact of changes in the health care environment on pregnant women and ACNM certified midwives. This partnership is presented as an example of how the ACNM has evolved into an organization that is well-positioned to preserve midwifery in a managed care environment.

Certification↗

PubMedDate not supplied

Bedside clinical guidelines: the missing link.

Clinical guidelines for acute general (adult) medicine, general (adult) surgery, nursing and acute paediatrics, for use at the bedside, were developed over 10 years in North Staffordshire. The guidelines have been adopted by 15 other hospitals, all members of the Bedside Clinical Guidelines Partnership. The guidelines include advice on clinical management, prescribing aids, and practical procedures. Recommendations are validated against published evidence, and provide the 'missing link' between this evidence and practical clinical care, by taking current consensus into account. The guidelines are clear, brief and specific, informing and guiding the actions of clinicians. Annual updating involves checking evidence and compatibility with national recommendations, and soliciting feedback from users to eliminate ambiguity or misunderstanding. Continued human effort and financial investment are required to ensure that the guidelines remain a 'living' document.

Adult↗

PubMed1998

Primary Health Care and partnerships: collaboration of a community agency, health department, and university nursing program.

Health care reform proposals emphasize health care that is essential, practical, scientifically sound, coordinated, accessible, appropriately delivered, and affordable. One route to achievement of improved health outcomes within these parameters is the formation of partnerships. Partnerships adopting the philosophy and five principles of Primary Health Care (PHC) focus on health promotion and prevention of illness and disability, maximum community participation, accessibility to health and health services, interdisciplinary and intersectoral collaboration, and use of appropriate technologies such as resources and strategies. A community service agency serving a multicultural population initiated a partnership with a health department and a university undergraduate nursing program. The result was a preschool health fair and there were benefits for each partner-benefits which could not have been realized without the collaboration. The health fair partnership planning, implementation, and evaluation process was guided by a framework shaped by the philosophy and five principles of PHC. The educational process described can be applied to other learning experiences where the goal is to help students understand and apply the concepts of PHC, develop myriad nursing competencies, and form collaborative relationships with the community and health agencies. Community health care dilemmas and nursing education challenges can be successfully addressed when various disciplines and sectors form effective partnerships.

British Columbia↗

PubMedDate not supplied

Use of a taxonomy to describe parish nurse practice with older adults.

Parish nursing in a new model of health care delivery in which practitioners build partnerships to extend health care from institutions into the community. The study discussed in this article focused on the applicability of the North American Nurses Diagnosis Association taxonomy and the Nursing Intervention Classification to describe parish nurse practice with older adults. Findings from this study may help develop a framework for the practice.

Aged↗

PubMed1990

Monitoring physicians. A bargaining model of medical group practice.

This paper challenges the proposition that large physician-owned groups will be inefficient because of failures to control opportunism. A bargaining model implies that even large partnerships will make efficient resource and monitoring decisions. In addition, opportunism has much the same payoff for employees and partners. The data show that most large medical practice organizations are physician owned. Empirical analyses of nine forms of monitoring by large groups generally show no clear link between monitoring and ownership. There is one exception. Physician-owned firms tend to base compensation on productivity, which may help explain the continued dominance of professional partnerships.

Cohort Studies↗

PubMed1997

The workload of trainees in general practice.

During their first training period in general practice the authors felt that they did not encounter the balanced workload which is the foundation for learning to be a GP. Previous studies confirmed the existence of differences in overall and specific workload between trainees and trainers. From their own experience and from the relevant literature they addressed several factors which might affect the workload of trainees. A study was undertaken to determine differences in workload between trainees and trainers, and to investigate whether certain characteristics of practice and of trainees affect the workload of trainees. Details of surgery consultations with 34 trainee-trainer partnerships were recorded in the north of the Netherlands over 2 weeks. Questionnaires were filled in by trainers, trainees and practice assistants from these 34 general practices. The total number of contacts recorded was 10,103. It was found that trainees see fewer elderly and female patients, less chronic and oncological conditions, but more minor illnesses. They see only 30% of patients with problem behavior. Factors that influence the trainees' workload, as compared to their trainers' are: list size; selection in the allocation of patients; trainee's experience prior to starting the training stage, and the trainee's sex. Except for problem behaviour, trainees generally see a cross-section of their trainer's practice population. Selection would provide a more balanced workload for trainees.

Aged↗

PubMed2004

Understanding our context for occupational therapy practice: a key to strategies for future success.

The future holds great promise for occupational therapists. Our success in utilizing the opportunities afforded by continuing changes in health care depend on our ability to recognize and act on potential beneficial trends as well as effectively address our challenges. Development of effective partnerships, obtaining required new knowledge and skills, ongoing commitment to evidence-based practice and quality service and demonstrating personal and collective responsibility for advocacy and promotion are key factors for our ability to prosper in these changing times.

Education, Medical, Continuing↗

PubMed1992

Community and university--partners in research.

Community-based and university-based family practice researchers must come together and merge into a synergistic partnership. Community-based researchers often need the special expertise of university statisticians, epidemiologists, and research methodologists, and the enthusiasm of fellow researchers. University-based researchers look to the community for subjects and the all-important factor of generalizability. We must no longer rely on serendipity to bring community- and university-based researchers together. Community-based people must acknowledge their needs and actively seek out assistance. The university-based departments can respond by deliberately starting outreach programs, setting up buddy systems, engaging community research consultants, and tracking residents and urging them to continue to do research. Sentinel networks can increase the depth of involvement community researchers have with their own, and others', projects. Such efforts will lead to a creative interrelationship that will be rewarding and enjoyable for us all.

Family Practice↗

PubMed1997

Concurrent partnerships and the spread of HIV.

OBJECTIVE: To examine how concurrent partnerships amplify the rate of HIV spread, using methods that can be supported by feasible data collection. METHODS: A fully stochastic simulation is used to represent a population of individuals, the sexual partnerships that they form and dissolve over time, and the spread of an infectious disease. Sequential monogamy is compared with various levels of concurrency, holding all other features of the infection process constant. Effective summary measures of concurrency are developed that can be estimated on the basis of simple local network data. RESULTS: Concurrent partnerships exponentially increase the number of infected individuals and the growth rate of the epidemic during its initial phase. For example, when one-half of the partnerships in a population are concurrent, the size of the epidemic after 5 years is 10 times as large as under sequential monogamy. The primary cause of this amplification is the growth in the number of people connected in the network at any point in time: the size of the largest "component'. Concurrency increases the size of this component, and the result is that the infectious agent is no longer trapped in a monogamous partnership after transmission occurs, but can spread immediately beyond this partnership to infect others. The summary measure of concurrency developed here does a good job in predicting the size of the amplification effect, and may therefore be a useful and practical tool for evaluation and intervention at the beginning of an epidemic. CONCLUSION: Concurrent partnerships may be as important as multiple partners or cofactor infections in amplifying the spread of HIV. The public health implications are that data must be collected properly to measure the levels of concurrency in a population, and that messages promoting one partner at a time are as important as messages promoting fewer partners.

Computer Simulation↗

PubMed2005

Partnership working between university researchers and self-advocacy organizations: 'A way forward for inclusion?'in England and 'Fine feathers make a fine bird'in Flanders.

This article gives accounts of differing experiences of self-advocate partnerships in research with universities in England and Flanders. In England the partnership grew up within a local People First group built upon a personal working relationship with one support person. It is focused almost exclusively on empirical research and, because it is aimed at influencing policy and practice, questions of funding and control are to the fore. In Flanders the partnership is closely linked with the development of a national movement of self-advocates in which the university was a close ally. Research is important in both contexts but in Flanders the university is more clearly identified with the wider movement. Partnerships have their ups and downs but in both countries researchers with the label 'learning difficulties' wish to set their own agendas and place great importance on trust in their work with their support worker (England) or ally (Flanders).

Belgium↗

PubMed1996

Reasons for non-attendance at a day hospital for people with enduring mental illness: the clients' perspective.

This paper describes a research project which aimed to discover the reasons clients give for failing to attend a mental health day hospital. There was concern that this service provision, for people with enduring mental illness, had a high level of non-attendance and therefore might not be meeting the needs of the people for whom it is targeted. Over a period of 6 months 36 people failed to attend, despite assessment and apparent agreement to attend. Of the 36, 14 agreed to talk about their reasons for not attending. An open interview format was used which enabled the clients to talk in depth about their experiences, which they felt led to the decision to stop attending. Content analysis of the interview data resulted in the identification of common themes. Main findings suggest a lack of partnership in decisions on choice of therapy, particularly the emphasis on groupwork, which 86% found unhelpful. Other main factors for non-attendance were a lack of an individual approach to care, not being listened to, and a lack of warmth from the staff. Recommendations for future practice are given, with particular attention to the need to develop a partnership with clients aimed at meeting individual needs.

Day Care, Medical↗

PubMed1997