The role of community representatives on health service committees: staff expectations vs. reality

Objective This paper examines staff views about legitimacy of different roles for community representatives sitting on health service committees as part of a formal Community Participation Program (CPP) in an Area Health Service (AHS) in Australia. Design A cross‐sectional survey using a self‐completed questionnaire by staff on committees with community representation in the AHS in 2008. Setting The study site has a population of approximately 1.4 million and covers 6000 km². The population is ethnically and socio‐economically diverse. Results There are generally positive staff attitudes at this AHS for community participation as part of the CPP with positive impacts identified, including on service delivery and the conduct of health service meetings. Most saw community representatives having legitimate roles in representing the community, improving communication between the health service and the community and providing constructive feedback. However, staff expectations about the community’s role on committees do not match the reality they say they observe and less than half the staff thought the community and health service agree on the role of community representatives. Conclusions As well as reviewing and enhancing training and support for representatives and staff as part of the CPP, there is a need to question staff expectations about community members who sit on health service committees and whether these expectations are shared by other key stakeholders, most notably the community representatives themselves. These expectations have implications for the CPP and for similar programs designed to engage community members on committees and working groups with health professionals.     

社区卫生服务人员激励实证研究

基于马斯洛需要层次理论,结合社区卫生服务的特征及基层绩效工资改革的背景,构建社区卫生服务人员激励需要指标体系,并进行探索性和验证性因子分析,验证该指标体系的有效性和稳定性。实证分析A市社区卫生服务人员激励问题,提出相应的对策建议。     

Health insurance literacy in community health center staff

Aim

Community health center (CHC) staff play a key role in connecting vulnerable patients to health services. This study aims to gauge the health insurance literacy (HIL) of CHC staff and identify factors associated with HIL.

Subjects and methods

One hundred and fifty-two staff members from three health centers completed an anonymous survey that assessed their knowledge and confidence in utilizing health insurance plans.

Results

Multivariate logistic regression was performed to identify predictors of HIL. The average HIL score among CHC staff was 6.3 out of 10. Education, occupation, race/ethnicity, and self-reported health status were all significantly associated with average HIL score.

Conclusion

The results of this study demonstrate a need for health insurance training among staff who help patients navigate health care.

     

Community care staff attitudes towards delivering a falls prevention exercise intervention to community care clients

Millions of older people world-wide receive community care services in their home to assist them to live independently. These services often include personal care, domestic assistance and social support which are delivered by non-university trained staff, and are frequently long term. Older people receiving community care services fall 50% more often than individuals of similar age not receiving services. Yet, few ongoing community care services include exercise programs to reduce falls in this population. We conducted an earlier study to examine the feasibility of community care staff delivering a falls prevention program. A critical finding was that while some of the assessment and support staff responsible for service delivery delivered the falls prevention exercise program to one or two clients, others delivered to none. Therefore, the aim of this qualitative sub-study was to understand reasons for this variation. Semi-structured interviews were conducted with 25 participating support staff and assessors from 10 community care organisations. Staff who had successfully delivered the intervention to their clients perceived themselves as capable and that it would benefit their clients. Older clients who were positive, motivated and wanted to improve were perceived to be more likely to participate. Staff who had worked at their organisation for at least 5 years were also more likely to deliver the program compared to those that had only worked up to 2 years. Staff that did not deliver the intervention to anyone were more risk averse, did not feel confident enough to deliver the program and perceived their clients as not suitable due to age and frailty. Experienced staff who are confident and have positive ageing attitudes are most likely to deliver falls prevention programs in a home care organisation.     

医疗市场细分与社区卫生服务的政策安排

本文分析了医疗市场细分的特征及其基本趋势，在此基础上界定社区卫生服务可能存在的目标医疗市场。进而总结这一医疗目标市场的需求特征与现有社区卫生服务机构之间的矛盾，并从资金、人员、业务三个方面提出社区卫生服务发展的政策安排。     

Survey of NHS staff attitudes to influenza immunisation

There was a low uptake of influenza vaccination among health care workers in year 1999-2000. The study aimed to identify reasons for low uptake and to use the results to improve uptake during current and future campaigns.     

Hospice staff attitudes towards telehospice

Telemedicine, defined as the use of advanced telecommunication technologies to bridge geographic distance and improve delivery of care, is perceived by many as a way to eliminate barriers to quality care at the end of life. The use of telemedicine in hospice, known as telehospice, is a novel approach to such care, and few pilot studies have investigated its feasibility. The purpose of this study was to assess hospice providers 'perceptions of telehospice. A focus group session was conducted with 10 staff members from five hospice agencies in Missouri. Participants included administrators, nurses, and social workers. Overall, providers had a positive perception of telehospice and found that the use of videophone technology enhanced care by enabling providers, patients, and family members a means to communicate. However, they emphasized that it was an additional tool and not a substitute for actual visits. Issues of privacy and usability were also raised.