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Correia T, Ricciardi W, McKee M. Preparing for the 'next pandemic': Why we need to escape from our silos. Int J Health Plann Manage 2024. [PMID: 38225891 DOI: 10.1002/hpm.3757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2024] Open
Abstract
The COVID-19 pandemic revealed major failings in many countries. We argue that one of the reasons, at global, national, and local levels, was that those involved were working in silos, unable to bring together the many diverse perspectives needed to respond to this complex problem. This is despite a growing recognition of the importance of adopting a Health For All Policies approach. Silo working, and the problems it creates, are not unique to health policy so there are opportunities to learn from those organisations that have tackled this issue.
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Affiliation(s)
- Tiago Correia
- Associate Laboratory in Translation and Innovation Towards Global Health, LA-REAL, Global Health and Tropical Medicine, GHTM, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisboa, Portugal
- WHO Collaborating Center for Health Workforce Policies and Planning, Instituto de Higiene e Medicina Tropical, IHMT, Universidade Nova de Lisboa, UNL, Lisbon, Portugal
| | - Walter Ricciardi
- Department of Life Sciences and Public Health, Università Cattolica Del Sacro Cuore, Rome, Italy
| | - Martin McKee
- Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK
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Hemmings A, Sharpe H, Allen K, Bartel H, Campbell IC, Desrivières S, Dobson RJ, Folarin AA, French T, Kelly J, Micali N, Raman S, Treasure J, Abbas R, Heslop B, Street T, Schmidt U. EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People): project outline. BJPsych Bull 2023; 47:328-336. [PMID: 36545688 PMCID: PMC10694679 DOI: 10.1192/bjb.2022.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Revised: 11/01/2022] [Accepted: 11/04/2022] [Indexed: 12/24/2022] Open
Abstract
EDIFY (Eating Disorders: Delineating Illness and Recovery Trajectories to Inform Personalised Prevention and Early Intervention in Young People) is an ambitious research project aiming to revolutionise how eating disorders are perceived, prevented and treated. Six integrated workstreams will address key questions, including: What are young people's experiences of eating disorders and recovery? What are the unique and shared risk factors in different groups? What helps or hinders recovery? How do the brain and behaviour change from early- to later-stage illness? How can we intervene earlier, quicker and in a more personalised way? This 4-year project, involving over 1000 participants, integrates arts, design and humanities with advanced neurobiological, psychosocial and bioinformatics approaches. Young people with lived experience of eating disorders are at the heart of EDIFY, serving as advisors and co-producers throughout. Ultimately, this work will expand public and professional perceptions of eating disorders, uplift under-represented voices and stimulate much-needed advances in policy and practice.
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Affiliation(s)
- Amelia Hemmings
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Karina Allen
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | - Iain C. Campbell
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Sylvane Desrivières
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard J.B. Dobson
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- Health Data Research UK London, University College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at University College London NHS Foundation Trust, London, UK
| | - Amos A. Folarin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Institute of Health Informatics, University College London, London, UK
- National Institute for Health and Care Research Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, London, UK
| | | | | | - Nadia Micali
- University College London, London, UK
- Psychiatric Research Centre Ballerup, Ballerup, Denmark
| | | | - Janet Treasure
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | | | | | | | - Ulrike Schmidt
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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Murphy C, Mullen E, Hogan K, O’toole R, Teeling SP. Streamlining an existing hip fracture patient pathway in an acute tertiary adult Irish hospital to improve patient experience and outcomes. Int J Qual Health Care 2019; 31:45-51. [PMID: 31867664 PMCID: PMC6926383 DOI: 10.1093/intqhc/mzz093] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 07/11/2019] [Accepted: 09/06/2019] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE To improve access for hip fracture patients to surgery within 48 h of presentation to the Emergency Department, and to increase the number of patients receiving pre-operative orthogeriatric review, through streamlining an existing hip fracture patient pathway. DESIGN A pre-post design involving a multi-disciplinary team use of the Define, Measure, Analyse, Improve and Control framework integral to Lean Six Sigma (LSS) methodology, to assess and adapt the existing hip fracture pathway from presentation to Emergency Department to the initiation of surgery. SETTING A 600-bed teaching hospital in Ireland. PARTICIPANTS Nursing, medical, administrative and physiotherapy staff working across Emergency Medicine, Orthogeriatrics and Orthopaedic Specialities and Project management. INTERVENTIONS LSS methodology was used to redesign an existing pathway, improving patient access to ortho-geriatrician assessment, pain relief and surgery in line with the Irish Hip Fracture Data Base Key performance indicators. MAIN OUTCOME MEASURES Access to pain relief, access to surgery and volume of patients receiving ortho-geriatric assessment. RESULTS The percentage of patients undergoing surgery within 48 h of presentation to Emergency Department increased from 55% to 79% at 3 months, and to 85% at 6 months. Improvements were also achieved in the secondary performance metrics relevant to quality of patient care. All care pathway changes were cost neutral. CONCLUSIONS Hip fracture surgery within 48 h of presentation to hospital is a recognized standard of hip fracture care associated with decreased length of stay and decreased mortality. With respect to this performance metric, this intervention has contributed to improved patient outcomes.
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Affiliation(s)
- Caitriona Murphy
- Physiotherapy Department, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Eithne Mullen
- Service Improvement Team, Ireland East Hospital Group, c/o Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - Karrie Hogan
- Cancer and Surgery Directorate, Mater Misericordiae University Hospital, Eccles Street, Dublin 7, Ireland
| | - ronan O’toole
- Department of Medicine for the Elderly, University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Seán Paul Teeling
- School of Nursing, Midwifery and Health Sciences, University College Dublin, Belfield, Dublin 4, Ireland
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Wallace C, Chandler L, Rogers A, Crosby K, Joshi N, Spriggs T, Hill C. Caring for fail patients: best practice. Nurs Stand 2012; 26:50-58. [PMID: 28071381 DOI: 10.7748/ns.26.28.50.s52] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Frailty has become synonymous with vulnerability and is a state caused by many factors, including disability, recurrent infection and multiple co-morbidities. The Gwent frailty service recognises the importance of an interdisciplinary approach to care, including timely recognition of frailty in patients and referral to the most appropriate services to optimise management and treatment.
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Affiliation(s)
- Carolyn Wallace
- Faculty of Health, Sport and Science, University of Glamorgan, Pontypridd
| | - Lynda Chandler
- Frail Older Persons Service Delivery Programme, Cardiff and Vale of Glamorgan, Whitchurch Hospital, Cardiff
| | - Audrey Rogers
- Rapid Response, Aneurin Bevan Health Board, Ebbw Vale Health Centre, Blaenau Gwent
| | - Kate Crosby
- Monmouthshire Locality, Aneurin Bevan Health Board, Chepstow Hospital, Chepstow
| | - Nimisha Joshi
- Intermediate Care Facility, St Woolos Hospital, Aneurin Bevan Health Board, Newport
| | | | - Chris Hill
- Aneurin Bevan Health Board, Mamhilad House, Pontypool
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