Thesis (M.P.A.)--University of Hong Kong, 2002. / Includes bibliographical references. Also available in print.

Aim: To examine the adoption of CCDS by paramedics, including the impact of CCDS on paramedic role and practice. Methods: Systematic review of CCDS in emergency care followed by a cluster-randomised controlled trial (C-RCT) of CCDS with a qualitative component involving 42 paramedics at two study sites. Results: 19/20 studies identified for inclusion in the systematic review were from the Emergency Department setting, with no studies from prehospital care. The focus of the studies was on process of care (19/20) rather than patient outcomes (5/20). Positive impacts were reported in 15/19 (79%) process of care studies. Only two patient outcome studies were able to report findings (one positive, one negative). Results relating to CCDS implementation were reported as an ad hoc response to problems encountered. In this C-RCT paramedics used CCDS with 12% of eligible patients (site one: 2%; site two: 24%). Intervention paramedics were twice as likely to refer patients to a falls service as those in the control group (usual care) (relative risk = 2.0; 95% Cl 1.1 to 3.7) although conveyance rates were unaltered (relative risk = 1.1; 95% Cl 0.8 to 1.5) and episode of care was unchanged (-5.7 minutes; 95% Cl -38.5 to 27.2). When CCDS was used patient referral to falls services was three times as likely (relative risk = 3.1; 95% Cl 1.4 to 6.9), and non-conveyance was twice as likely (risk = 2.1; 95% Cl 1.1 to 3.9) and overall episode of care fell by 114 minutes (95% Cl from 77.2 to 150.3). Reasons given for not using CCDS included technical problems, lack of integration, it was not sophisticated enough to influence decision making. Paramedics adapted when and how they used CCDS to suit context and patient condition. Conclusion: There is little existing evidence in relation to CCDS use in the emergency care setting, and the prehospital emergency care setting in particular. Studies of CCDS undertaken in emergency departments have shown benefit, particularly in relation to process of care. The C-RCT found that CCDS use by paramedics was low, particularly at site one, but use was associated with higher rates of patient referral and non-conveyance, and shorter episodes of care. There were encouraging signs that CCDS can support a new decision making role for paramedics. The study provides useful lessons for policy makers, practitioners and researchers about the potential benefits of CCDS and the challenges to adoption of new technology in emergency prehospital care.

The growing number of candidates for allied health programs and the continued quest for identification of ideal candidates increases the pressure for allied health programs to continually improve their selection process. Despite past and recent research and the significant amount of literature on admission criteria for selective allied health programs, there is limited research on faculty perceptions of the interview as part of the admission criteria. For this study, interviews were conducted with fifteen allied health faculty members who teach in a program with selective admissions. The interviews consisted of seven open-ended questions and were audio-recorded, then transcribed through Temi.com. The transcriptions were analyzed for common themes. The participants agreed that an interview is an important component of the selective admissions criteria particularly for assessing the candidate’s ability to communicate and interact with others.

This study uncovers the experiences of Latinos/as in allied health graduate programs and provides vital information which may help increase the number of Latino/a healthcare providers. It focuses on the testimonios (life narratives) of 9 Latinos/as who graduated from allied health graduate programs. Academic resilience and community cultural wealth theories framed the study while testimonio methodology guided data collection. Alumni were interviewed about the personal experiences and educational journeys that led them to successfully complete graduate allied health degrees. Participants’ family background, educational history, personal and environmental factors were considered. Participants described learning about the value of education early in their lives in home and school settings. The interviews also revealed the importance of participants’ personal drive and desire to excel academically and professionally. Participants noted that the academic rigor and adjustment required to succeed in graduate allied health programs, combined with feelings of social isolation, made their transition to the graduate program challenging. Family and social networks were noted as the most supportive in regards to participants’ retention and success. Research implications include the use of methodologies and theoretical frameworks which focus on the voices and experiences of underrepresented students in the allied health professions. Implications for allied health schools include intentional recruitment of underrepresented student populations, the establishment of social support systems, student affairs offices, and the inclusion of social class, ethnicity, and cultural diversity as standards by which allied health schools are rated for accreditation and re-accreditation purposes.

The Healthcare Quality Strategy for NHS Scotland, relates its overall vision of healthcare quality to six dimensions of care as: Safe, Efficient, Effective, Equitable, Timely and Patient Centred. Patient Centred Care also underpins many subsequent policies such as the management of Long Term Conditions (Scottish Government, 2008) and the Chief Medical Officers Realistic Medicine report (Barlow, et al., 2015) Leadership styles and associated policies and procedures are often assumed to inhibit or encourage the delivery of quality Patient Centred Care and the NHS invests millions of pounds per year in Leadership training. At a clinical team and management level there are behaviours and initiatives that can arguably have positive and negative impacts on the ability of individual practitioners to provide quality Patient Centred Care. However there have been no attempts to empirically test the association between (good) Leadership and quality Patient Centred Care. Without any evidence of such a relationship, NHS investment of substantial resources may be misguided. Additionally, much of the focus of research in both Leadership and Patient Centred Care has focused on medical practitioners and nurses. There is little research that focuses on the impact of allied health professionals' (a term describing 12 differing health care professional groups representing over 130,000 clinicians throughout the United Kingdom) practice on the quality of person centred care and how this is affected by Leadership structures and styles. This study aimed to explore whether there is a direct or indirect link between (transformational) Leadership and achieving the delivery of high quality Patient Centred Care (PCC) in allied health professional (AHP) practice. Aim The aim of this thesis was to explore whether it was possible to empirically demonstrate a relationship between Leadership (good or bad) and Patient Centred Care, and to do this in relation to Allied Health Professional practice. Research questions I. Is there a relationship between Transformational Leadership and Patient Centred Care in AHP practice? II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? III. Do local contexts influence the ability of leaders to support Patient Centred Care? Study one Study one was designed to answer research question one: exploring the relationship between transformational Leadership and Patient Centred Care using survey design. Two groups of Allied Health Professionals were selected to take part in the study: Podiatrists and Dieticians. Clinical team leaders from across 12 Podiatry teams and 12 Dietetic teams completed a survey composed of measures of transformational Leadership and self-monitoring. Clinicians from these teams were also be asked to complete questionnaires on their perception of their clinical leaders’ transformational Leadership skills. This allowed comparison of self-assessed Leadership and team assessed Leadership. Clinicians were also asked to collect patient experience measures from 30 of their patients. Study Two Study Two was designed to answer research questions 2 and 3: how do AHPs conceptualise Leadership and how do they view the link between Leadership and their ability to deliver Patient Centred Care; and how might local context impact on professional Leadership and therefore its potential to enable or inhibit Patient Centred Care. In depth interviews were conducted with clinicians and clinical team leaders to explore the barriers and facilitators to effective Leadership, teamwork and the provision of quality care. Interviews were conducted with 21 Podiatrists and 12 Dieticians and analysed using a framework analysis approach. Results I. Is there a relationship between Patient Centred Care and transformational Leadership in AHP practice? The theory that there is a link between transformational Leadership and Patient Centred Care was confirmed. A significant relationship was discovered for the dietetics group linking Transformational Leadership with patient centred quality of care measures. There was also a relationship in the podiatry group that was suggestive of a relationship. II. How do AHP’s conceptualise Leadership and its impact on their ability to deliver PCC? AHP’s in both groups had broadly similar conceptualisations of Leadership and both groups played down the role of Leadership in the delivery of Patient Centred Care. A far more salient factor in achieving the delivery of high quality Patient Centred Care for the AHP’s interviewed was professional autonomy. III. Do local contexts influence the ability of leaders to support Patient Centred Care? A number of contextual issues related to both Patient Centred Care and Leadership were identified from the qualitative analysis. These were centred on systemic factors, relating to management and bureaucracy, and individual factors, such as relationships within teams. In Podiatry a major shift in the context of care was ongoing during the study, namely a greater emphasis on encouraging patients to self-care. This affected the relationships between patients and Podiatrists, and Podiatrists and managers, in a way that Podiatrists felt it negatively impacted on their ability to provide quality Patient Centred Care. Conclusion A weak relationship was observed between Transformational Leadership styles and the delivery of Patient Centred Care in two Allied Health Professional groups. Professional autonomy was identified as being more likely to facilitate delivery of person centred care. Organisational issues and intervening policy directives can impact on the delivery of Patient Centred Care, regardless of Leadership. Recommendations Further work exploring the link between Leadership and Patient Centred Care is required. The concept of professional autonomy should be fostered within Leadership programs to enhance delivery of Patient Centred Care. The impact of individual policies, such as moves towards more self-care, on quality criteria need to be more fully considered. Whilst such policies may make care more efficient, there may be negative consequences for other quality care criteria, such as Patient Centred Care.

Interprofessional education has the potential to prepare health career students to be practice-ready and enter the workforce with a collaborative mindset. Respiratory care educators must adequately prepare students to work in this capacity. This emphasis on a team approach to patient-centered care has the ability to impact and improve health outcomes. Throughout the last decade, sleep medicine has experienced fluctuations. Sustainability of sleep labs who only perform diagnostic testing may prove challenging. The role of interprofessional practice in sleep medicine would be to overcome traditional roles (silos) so that multiple skilled practitioners could help identify and treat complex patient conditions. A review of the literature demonstrated how various providers can serve as active members of interprofessional health care teams. The opportunity to expand services and partner with other providers to detect, educate, and treat sleep disordered breathing could help laboratories endure and even thrive in the current health care system.

Excerpt: The World Health Organization describes inter-professional education (IPE) as being when studentsfrom at least two professions learn about, from, and with each other to facilitate effective collaboration among health care providers and improve patient health outcomes.

Thesis (M.S.)--Rutgers University, 2008. / "Graduate Program in Psychology." Includes bibliographical references (p. 36-38).

Thesis (M.Psych.Org.) - University of Queensland, 2006. / Includes bibliography.

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