Routine outcomes monitoring as part of children and young people's Improving Access to Psychological Therapies (CYP IAPT) – improving care or unhelpful burden?

This brief commentary article considers the implications of intensive outcome monitoring which is central to children and young people's Improving Access to Psychological Therapies (CYP IAPT) in England and Wales. Services are being provided with a range of free software solutions to enable data collection, and guidance on interpretation of the measures, but there will still be some burden of data entry and collation for already overstretched services. It may be that the utility of the feedback will go some way to offset the sense of burden but this remains to be seen. Whether commissioners and others will rise to the challenge of supporting this aspect may prove crucial to the success or otherwise of such intensive ROM use. Many aspects of the CYP IAPT approach are new and whilst drawing on experience from earlier pilots of session by session monitoring in CAMHS both in the UK and abroad, and from Adult IAPT, there is likely to be much for us to learn. Time will tell whether the approach helps to improve the care children and young people receive but we are cautiously optimistic.     

Propuesta metodológica para explorar la compra de alimentos saludables y sostenibles en servicios de alimentación

ObjectiveDescribe the methodology used to explore sustainability and nutritional aspects of institutional food service purchasing.MethodThe source of information is the purchasing list. This document includes information on the ingredients used to prepare meals, such as the quantity (kg), variety (n), origin (local farmers or other suppliers) and type of production (organic or conventional) of food items.ConclusionThe described methodology allows obtain a wider vision of the quality of the meals offered in the food services. In addition to nutritional aspects, this methodology incorporates the perspective of sustainability.     

Patient satisfaction with physiotherapy services in an Asian country: A report from Sri Lanka

Patient satisfaction is an important indicator of the quality of care provided to recipients of health services. In Sri Lanka, there is a dearth of research on patient satisfaction, particularly in the arena of physiotherapy services. Such research is important to address any issues in the physiotherapy service, such that patients' needs are better catered for, as well as to improve the marketability of physiotherapy services. The present study aimed to investigate patient satisfaction with the physiotherapy treatment received at a large government hospital in Sri Lanka. A cross-sectional survey study was conducted on a sample of 150 patients receiving physiotherapy treatment using a self-administered questionnaire. This was followed by a focus group discussion. Results indicated that the majority of patients were satisfied with the treatment received. Information on selected correlates of patient satisfaction such as physiotherapist-related factors, patient-related factors, nature of the physiotherapist–patient interaction, professionalism of the service provided, and the logistics of the treatment environment was discussed.     

Respiratory Health in Latin America: Number of Specialists and Human Resources Training

Latin America is made up of a number of developing countries. Demographic changes are occurring in close to 600 million inhabitants, in whom a significant growth in population is combined with the progressive ageing of the population. This part of the world poses great challenges for general and respiratory health. Most of the countries have significant, or even greater, rates of chronic respiratory diseases or exposure to risk. Human resources in healthcare are not readily available, particularly in the area of respiratory disease specialists. Academic training centres are few and even non-existent in the majority of the countries.The detailed analysis of these conditions provides a basis for reflection on the main challenges and proposals for the management and training of better human resources in this specialist area.     

Frailty and health service use in rural South Australia

BackgroundFrailty is a common geriatric condition, well known to contribute to morbidity and mortality. What is not yet well articulated in the literature is the health service use of frail older people in rural areas. This study investigated the impact of frailty on health service use in rural South Australia.MethodsThis secondary cross-sectional analysis included people aged ≥65 years from the LINKIN health census in Port Lincoln. Frailty was classified using a Frailty Index (FI) score ≥0.25. Health service use was determined by patient questionnaire. All regression analyses controlled for age, gender and education level.Results1501 people [mean (SD) age = 75.9 (7.9)] years were included. Frailty prevalence was 25%, with this prevalence higher in females (29%) than in males (21%). Compared with their non-frail peers, frail adults were more likely to have consulted health providers, including: general practitioners (GPs) (odds ratio (OR), 95% confidence interval (CI = 2.09, 1.24–3.53); physiotherapists (OR, CI = 2.42, 1.80–3.25); mental health providers (OR, CI = 2.88, 1.42–5.85); community nurses (OR, CI = 2.57, 1.73–3.82); and dieticians (OR, CI = 2.77, 1.77–4.48). They were also more likely to have visited a health professional prior to a problem occurring (OR, CI = 1.51, 1.08–2.11), travelled to the city for a specialist appointment (OR, CI = 1.53, 1.11–2.11), and to have been hospitalised in the previous 12 months (OR, CI = 2.39, 1.74–3.29).ConclusionFrail older adults were more likely to use several health services, yet often had unmet needs in their health care.     

The knowledge desired by emergency medical service managers of their ambulance clinicians – A modified Delphi study

AimThe aim of the study was to identify the types of knowledge that Swedish Emergency Medical Service (EMS) managers considered desirable in their Ambulance Clinicians.BackgroundEmergency medical service managers are responsible for organisational tasking and in this are dependent on the knowledge possessed by their ambulance clinicians. It would therefore be of value to explore EMS managers’ approach to this knowledge.DesignA modified Delphi method in three rounds.MethodsIn total thirty-six EMS managers participated, and twenty-four finished all three rounds. They were encouraged to rate each sub-category, and the ten with the highest mean were interdependently ranked in the final round.ResultsFive categories and twenty-six sub-categories emerged in the first round, covering knowledge related to; contextual aspects, medical and holistic assessments, formal education and organisational issues. Eventually, the sub-category ‘Knowledge to assess the patient’s situation from a holistic perspective’ was the highest ranked, followed by ‘Medical knowledge to assess and care for different diseases’ and ‘Knowledge to be able to care for critically ill patients’.ConclusionsTaken together the knowledge areas address essentially medical care, contextual aspects and nursing. The boundaries between these can sometimes be seen as elusive, calling for ambulance clinicians to balance these areas of knowledge.