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Healthcare Quality Improvement and 'work engagement';concluding results from a national, longitudinal, cross-sectional study of the 'Productive Ward-Releasing Time to Care' programme

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BMC HEALTH SERVICES RESEARCH 2017年第1期17卷 1-11页

作者： White, Mark Butterworth, Tony Wells, John S. G. Kilcreene Hosp Off Complex Nursing & Midwifery Planning & Dev Unit Kilkenny R95 DK07 Ireland Univ Lincoln Healthcare Workforce Innovat Brayford Pool Lincs England Waterford Inst Technol Sch Hlth Sci Waterford Ireland

Background: Concerns about patient safety and reducing harm have led to a particular focus on initiatives that improve healthcare quality. However Quality Improvement (QI) initiatives have in the past typically faltered because they fail to fully engage healthcare professionals, resulting in apathy and resistance amongst this group of key stakeholders. Productive Ward: Releasing Time to Care (PW) is a ward-based QI programme created to help ward-based teams redesign and streamline the way that they work;leaving more time to care for patients. PW is designed to engage and empower ward-based teams to improve the safety, quality and delivery of care. Methods: The main objective of this study was to explore whether PW sustains the 'engagement' of ward-based teams by examining the longitudinal effect that the national QI programme had on the 'work-engagement' of ward-based teams in Ireland. Utilising the Utrecht Work Engagement Scale questionnaire (UWES-17), we surveyed nine PW (intervention) sites from typical acute Medical/Surgical, Rehabilitation and Elderly services (representing the entire cohort of a national phase of PW implementation in Ireland) and a cohort of matched control sites. The numbers surveyed from the PW group at T1 (up to 3 months after commencing the programme) totalled 253 ward-team members and 249 from the control group. At T2 (12 months later), the survey was repeated with 233 ward-team members from the PW sites and 236 from the control group. Results: Overall findings demonstrated that those involved in the QI initiative had higher 'engagement' scores at T1 and T2 in comparison to the control group. Total 'engagement' score (TES), and its 3 dimensions, were all significantly higher in the PW group at T1, but only the Vigour dimension remained significantly higher at T2 (p = 0.006). Conclusion: Our results lend some support to the assertions of the PW initiative itself and suggest that when compared to a control group, ward-based teams involved i

关键词： Employee engagement Health service research Hospital units Lean healthcare Multidisciplinary care team Nurse attitudes Productive ward program implementation Quality improvement

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County-level outcomes of a rural breast cancer screening outreach strategy: a decentralized hub-and-spoke model (BSPAN2)

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TRANSLATIONAL BEHAVIORAL MEDICINE 2017年第2期7卷 349-357页

作者： Lee, Simon J. Craddock Higashi, Robin T. Inrig, Stephen J. Sanders, Joanne M. Zhu, Hong Argenbright, Keith E. Tiro, Jasmin A. Univ Texas Southwestern Med Ctr Dallas 5323 Harry Hines Blvd Dallas TX 75390 USA Harold C Simmons Comprehens Canc Ctr Dallas TX 75235 USA Mt St Marys Univ Los Angeles CA USA Montreal Canc Inst Ft Worth TX USA

Rural mammography screening remains suboptimal despite reimbursement programs for uninsured women. Networks linking non-clinical community organizations and clinical providers may overcome limited delivery infrastructure in rural areas. Little is known about how networks expand their service area. To evaluate a hub-and spoke model to expand mammography services to 17 rural counties by assessing county-level delivery and local stakeholder conduct of outreach activities. We conducted a mixed-method evaluation using EMR data, systematic site visits (73 interviews, 51 organizations), 92 patient surveys, and 30 patient interviews. A two-sample t test compared the weighted monthly average of women served between hub-and spoke-led counties;nonparametric trend test evaluated time trend over the study period;Pearson chi-square compared sociodemographic data between hub-and spoke-led counties. From 2013 to 2014, the program screened 4603 underinsured women. Counties where local "spoke" organizations led outreach activities achieved comparable screening rates to hub-led counties (9.2 and 8.7, respectively, p= 0.984) and did not vary over time (p = 0.866). Qualitative analyses revealed influence of program champions, participant language preference, and stakeholders' concerns about uncompensated care. A program that leverages local organizations' ability to identify and reach rural underserved populations is a feasible approach for expanding preventive services delivery.

关键词： Rural Breast cancer Healthdisparities Healthservices delivery Mixed methods program implementation

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A schoolwide investment in problem-based learning

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PHI DELTA KAPPAN 2017年第2期99卷 65-70页

作者： Sutton, Paul S. Knuth, Randy Pacific Lutheran Univ Educ Tacoma WA 98447 USA Knuth Res Spokane WA USA

A comprehensive high school in Bellevue, Wash., embraces problem-based learning as its strategy for improvement. Supported by a federal i3 grant, the school spent five years preparing for a widespread launch of PBL at the school. After several years of implementation, researchers learned that students perform the same or better on standardized measures when provided with sustained, rich PBL learning experiences. Those benefits were felt by all students, regardless of socioeconomic or linguistic status, or special learning needs.

关键词： Investment Problem Based Learning High Schools Educational Improvement Educational Strategies Learning Experience Achievement Gains Educational Change Educational Practices School Effectiveness Student Improvement program implementation Teacher EffectivenessWashington

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A Catalyst for Change: Service-Learning for TESOL Graduate Students

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TESOL JOURNAL 2017年第3期8卷 613-635页

作者： Cho, Hyesun Gulley, Jeremy Univ Kansas TESOL Dept Curriculum & Teaching Lawrence KS 66045 USA Univ Kansas Lawrence KS 66045 USA

This study explores ways in which TESOL graduate students were engaged in service-learning at a public university in the midwestern United States. It describes the experiences of both domestic and international students with service-learning that was incorporated into a hybrid graduate-level TESOL course. Data were collected throughout the semester through weekly discussions on Blackboard, three reflective journals in which students wrote about their experiences on-site, and in-person discussions in the classroom, as well as through a focus group interview at the end of the semester. Findings reveal how service-learning contributed to developing students' intercultural awareness, civic responsibility, and teacher identity. Students also appreciated the opportunity to share their experience with the class and receive support from their peers. Overall, servicelearning gave students hands-on experience that allowed them to translate theory into practice, thus making their learning authentic, creative, and meaningful. The findings raise important questions for TESOL educators and researchers to address as we reimagine and reconceptualize the curriculum for promoting diversity and social justice. The article concludes with suggestions for implementing service-learning in a TESOL program.

关键词： Graduate Students Service Learning Second Language Instruction English Teachers English Language Learners Data Collection Computer Mediated Communication Reflection Journal Writing Classroom Communication Cultural Awareness Citizenship Responsibility Professional Identity Experiential Learning Theory Practice Relationship program implementation

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What makes CLIL leadership effective? A case study

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ELT JOURNAL 2017年第4期71卷 478-490页

作者： Soler, David Gonzalez-Davies, Maria Inesta, Anna Univ Ramon Llull Fac Psychol Educ & Sport Sci Blanquerna Barcelona Spain Res Grp CILCEAL Interlinguist & Intercultural Com Barcelona Spain ESADE Business Sch Educ Innovat Barcelona Spain Univ Ramon Llull Foreign Languages Dept Fac Psychol Educ & Sport Sci Blanquerna Barcelona Spain Res Grp CILCEAL Barcelona Spain Univ Barcelona Sch Modern Languages Barcelona Spain Univ Vic Translat Dept Barcelona Spain Univ Ramon Llull ESADE Ctr Educ Innovat ESADE Business & Law Sch Barcelona Spain Univ Ramon Llull Bachelor Business Adm Barcelona Spain Univ Ramon Llull Innovat & Higher Educ Area Barcelona Spain

The swift growth of Content and Language Integrated Learning (CLIL) has caused a diversification of CLIL models designed to fit specific contexts. Although variation across programmes is inevitable, exploring the main factors for the effective implementation of CLIL may help avoid the risk of promoting inefficient practices. The main purpose of this article is to examine how three schools have implemented successful CLIL programmes in the Catalan context by analysing, from a leadership perspective, the perceptions and practices of the schools' principals, English department heads, and CLIL teachers. We applied a case study approach. The results elicited from surveys, interviews, and classroom observations reveal that these CLIL programmes benefitted from clear design, teacher training, collaboration, administrative support, and continued exposure of students to the target language. Participants perceived that distributed leadership facilitated the implementation of the programmes. Implications for CLIL programme leaders in similar contexts may be drawn from the study.

关键词： Case Studies Instructional Leadership Course Content Language of Instruction Administrator Effectiveness English (Second Language) Second Language Learning Second Language Instruction Teaching Methods program implementation Bilingual Education programs Teacher Education Principals Spanish Romance Languages Teacher Collaboration Administrator Attitudes Interviews Observation program Design Department Heads Teacher Attitudes

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Improved Delivery of Cardiovascular Care (IDOCC): Findings from Narrative Reports by Practice Facilitators

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Preventive Medicine Reports 2017年 5卷 214-219页

作者： Liddy, Clare Rowan, Margo Valiquette-Tessier, Sophie-Claire Drosinis, Paul Crowe, Lois Hogg, William C.T. Lamont Primary Health Care Research Centre Bruyère Research Institute Ottawa Ontario Canada Department of Family Medicine University of Ottawa Ottawa Ontario Canada Rowan Research & Evaluation Ottawa Ontario Canada Department of Psychology University of Ottawa Ottawa Ontario Canada

Practice facilitation can help family physicians adopt evidence-based guidelines. However, many practices struggle to effectively implement practice changes that result in meaningful improvement. Building on our previous research, we examined the barriers to and enablers of implementation perceived by practice facilitators (PF) in helping practices to adopt the Improved Delivery of Cardiovascular Care (IDOCC) program, which took place at 84 primary care practices in Ottawa, Canada between April 2008 and March 2012. We conducted a qualitative analysis of PFs’ narrative reports using a multiple case study design. We used a combined purposeful sampling approach to identify cases that 1) reflected experiences typical of the broader sample and 2) presented sufficient breadth of experience from each project step and family practice model. Sampling continued until data saturation was reached. Team members conducted a qualitative analysis of reports using an open and axial coding style and a constant comparative approach. Barriers and enablers were divided into five constructs: structural, organizational, provider, patient, and innovation. Narratives from 13 practice sites were reviewed. A total of 8 barriers and 11 enablers were consistently identified across practices. Barriers were most commonly reported at the organizational (n = 3) and structural level, (n = 2) while enablers were most common at the innovation level (n = 6). While physicians responded positively to PFs’ presence and largely supported their recommendations for practice change, organizational and structural aspects such as lack of time, minimal staff engagement, and provider reimbursement remained too great for practices to successfully implement practice-level changes. Trial Registration: ***, NCT00574808 © 2016

关键词： barriers cardiovascular care family physicians practice facilitation primary care program implementation

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Creating an Online Presence for Hybrid Support

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New Directions for Teaching and Learning 2017年第149期2017卷 103-109页

作者： Jerke, Darin Mosterd, Eric University of South Dakota United States

This chapter explores the web presence needed for instructors, students, administrators, and staff as hybrid courses are implemented at the institutional level and discusses the physical presence (office(s) and staff)... 详细信息

关键词： Blended Learning Web Sites Teacher Role Student Role Administrator Role program implementation Student Personnel Services

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Examining implementation of Intensive Intervention in Mathematics

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LEARNING DISABILITIES RESEARCH & PRACTICE 2017年第3期32卷 189-199页

作者： Schumacher, Robin F. Edmonds, Rebecca Zumeta Arden, Sarah V. Instruct Res Grp Los Alamitos CA 90720 USA Amer Inst Res Washington DC USA Amer Inst Res Natl Ctr Intens Intervent Washington DC USA Amer Inst Res Investing Innovat & Improvement i3 Dev Grant Washington DC USA Amer Inst Res Natl Ctr Intens Intervent Intens Tech Assistance Washington DC USA Amer Inst Res US Dept Educ Off Improvement & Innovat i3 Grant Washington DC USA

Promising findings from controlled research studies often fail to be transferred to and implemented in schools successfully. This problem is particularly apparent when considering implementation of evidence-based practices related to complex systems such as response to intervention (RTI) and other multitiered intervention frameworks in mathematics. This article addresses the challenges schools face when implementing intensive intervention in mathematics with a data-based individualization (DBI) framework. Preliminary findings from the first year of a formative evaluation study that addressed school-based implementation of DBI include (a) factors that impacted readiness for DBI, (b) the application of DBI at school sites, and (c) the importance of ongoing coaching and consultation. We then discuss practical implications for schools and districts when planning for intensive intervention in mathematics.

关键词： Mathematics Instruction Response to Intervention Evidence Based Practice Learning Disabilities program implementation Formative Evaluation Disabilities Mathematics Skills Intervention Educational Legislation Equal Education Federal Legislation

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Teaching Note-Meeting the Demand for Behavioral Health Clinicians: Innovative Training Through the GLOBE Project

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JOURNAL OF SOCIAL WORK EDUCATION 2017年第4期53卷 744-750页

作者： Sampson, McClain Univ Houston Houston TX 77204 USA

The national move toward integrated mental health and substance abuse service delivery has a significant impact on social work education and necessitates changes in how we train students. To address this need, the Global Leaders of Behavioral Health Education (GLOBE) training project was developed. GLOBE is a student training and stipend program that prepares students for clinical behavioral health practice in integrated care. This teaching note describes GLOBE, reports challenges encountered in its implementation, and provides strategies for overcoming them. The challenges include assigning students to grant-compliant field placements, engaging other health care professionals in the educational efforts, and implementing curriculum changes. Suggestions for social work program administrators interested in integrated care training are provided.

关键词： Mental Health Substance Abuse Social Work Teaching Methods Training Skill Development Health Services Barriers program implementation Student Placement Allied Health Personnel Curriculum Development Interdisciplinary Approach Experiential Learning Workshops Fellowships Grants Graduate StudentsTexas (Houston)

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Integrating Triple P into Existing Family Support Services: A Case Study on program implementation

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PREVENTION SCIENCE 2011年第4期12卷 411-422页

作者： Breitkreuz, Rhonda McConnell, David Savage, Amber Hamilton, Alec Univ Alberta Edmonton AB T6G 2N1 Canada Univ Alberta Family & Disabil Studies Initiat Edmonton AB T6G 2M7 Canada

The purpose of this paper is to present a case study of "evidence-based" program uptake and implementation. The process of integrating Triple P (levels 2 and 3) into existing family support centers in Alberta, Canada, was examined. We conducted ten individual interviews with directors, and ten group interviews, involving a total of 62 practitioners across ten Triple P pilot sites. Key findings show that there was variability in the approach and extent to which Triple P was integrated into family support centers. Five key factors impacting the integration process emerged from the interviews. These were: (1) the level of development of pre-existing support services;(2) the degree of "fit" between the Triple P program approach and existing agency practice, including the perceived suitability/unsuitability for some client groups;(3) practitioner perceptions of the adaptability of the program;(4) rules about who can and who cannot use Triple P resources;and (5) training and sustainability issues. In addition to identifying specific factors, this study was able to provide some insight as to why and how these factors were significant, thereby adding to the literature on knowledge/program dissemination processes.

关键词： Triple P program implementation Knowledge dissemination Evidence-based programs Parenting program

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