Journal of Health Services Research & Policy最新文献

{"title":"Does the English NHS 10-year health plan offer transformational change and a break with the past or more of the same?","authors":"David J Hunter","doi":"10.1177/13558196251395730","DOIUrl":"10.1177/13558196251395730","url":null,"abstract":"","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"69-71"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145445272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Review of residential and nursing care home policies on safety incident reporting in England.","authors":"Mel Steer, Kate Sykes, Justin Waring, Celia Mason, Pamela Dawson, Craig Newman, Lesley Young-Murphy, Michele Spencer, Jason Scott","doi":"10.1177/13558196251392508","DOIUrl":"10.1177/13558196251392508","url":null,"abstract":"<p><p>ObjectivesIn care homes, safety incident reporting, and the policy framework that surrounds safety incident reporting, is not well understood. This study aims to review safety incident reporting and safety policies in residential and nursing care homes in England. It aims to better understand safety incident reporting practices and identify lessons for the sector regarding approaches to safety incident reporting to improve safety. The objectives were to investigate what policies exist, identify the methods and any technology used for safety incident reporting and consider the data captured in safety incident reports. It aims to contribute to discussions regarding developing systems-based approaches to safety management in care homes.MethodsA qualitative documentary analysis of safety incident reporting policies in residential and nursing care homes in England was undertaken. Policies were collected from 23 organisations whose staff participated in interviews (n = 75) regarding safety incident reporting between January 2021 until June 2022 and from a structured internet search using specified search terms between April 2022 and May 2022. To be included, a policy needed to refer to safety incident reporting in any capacity and be partially or wholly related to care homes or nursing homes in England. Safety incidents could include staff, residents, contractors, and visitors to the home. Data, extracted using a bespoke framework based on study objectives, were tabulated and analysed deductively and inductively. For the selected policies, the Care Quality Commission website was searched for the latest inspection report and the overall rating was extracted.ResultsForty-one policy documents were retrieved and screened for inclusion. Twenty-five policies (from 23 organisations) were reviewed. Three were from the internet search and 22 were obtained from interview participants. There was considerable variability in the length and comprehensiveness of the policies, with some homes using untailored, 'off-the-shelf' standardised policies produced by a specialist company. Twenty-two (88%) referred to other policy and legislative documents important to safety incident reporting and all but three (12%) policies identified a designated person or role with responsibility for the reports. Only one policy incorporated resident accounts and views into the incident report. Two policies referred exclusively to electronic recording systems with most (n = 19) referring to paper-based reporting systems.ConclusionsThe study identified the extent of, and gaps, in safety incident reporting policies, with reporting practices situated within a broad framework of governance. Incident reporting is as much a matter of governance as practice and there may be a greater opportunity to learn from incident reports than there is currently. Further research about how staff navigate multiple risks, develop adaptive approaches for the contextual conditions, and use safety incident ","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"72-84"},"PeriodicalIF":2.2,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12988002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Maternity staff opinions on perinatal death reviews: Parent involvement and changes to standardising the system.","authors":"Emily O'Connor, Aenne Helps, Richard Greene, Keelin O'Donoghue, Sara Leitao","doi":"10.1177/13558196251395529","DOIUrl":"10.1177/13558196251395529","url":null,"abstract":"<p><p>ObjectivesPerinatal death review programmes collect perinatal mortality data and identify modifiable factors in preventable perinatal deaths. Reviews may provide closure and answers to bereaved parents. Many parents remain uninvolved in the review process. This qualitative study aimed to explore the opinions of maternity staff regarding the existing review system, parent involvement in reviews and standardising the review system.MethodsThis study involved interviews with staff from three maternity units in different locations around Ireland. A topic guide was used to guide the discussion. We spoke with staff members from different backgrounds and managerial levels, including doctors, midwives, patient advocates, risk managers and pastoral care. Thematic analysis was conducted to analyze the results.Results32 interviews were conducted between May and December 2022. Three themes and six associated subthemes were generated relating to communication with parents regarding review and their involvement in this process. Participants felt that parents were not involved enough in the review process and that communication with parents about reviews needed improvement. A parent advocate was viewed as important for guidance and support for parents during the review process. Facilitators included an easy-to-use, electronic review form and providing education about the review process. Barriers included local resistance to changing the process and lack of time to complete reviews.ConclusionPerinatal death reviews are not standardised in Ireland. Communication with parents and parent involvement in reviews could be improved. Highlighted facilitators and barriers should be addressed prior to implementing any proposed changes to the review system.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"98-109"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Taskification in general practice: A solution to, or an aggravator of, the workforce crisis?","authors":"Amanda N Rasmussen, Imelda Mcdermott, Sharon Spooner","doi":"10.1177/13558196251400266","DOIUrl":"10.1177/13558196251400266","url":null,"abstract":"<p><p>As a solution to the current international workforce crisis in general practice, many countries are introducing initiatives of task-shifting. These initiatives involve a tendency to 'taskification', which means that complex work is dissected into smaller tasks that are delegated between different healthcare professionals. Drawing on existing academic literature and international policy developments, this essay aims to problematise the idea of taskification as a solution to the workforce crisis in general practice. The concept of taskification is introduced and elaborated by tracing its roots to the theories of Taylorism and New Public Management. Like these organizational paradigms, the concept of taskification reflects a prioritization of efficiency, standardization, and managerial control, which may fragment healthcare delivery and undermine the holistic and discretionary nature that traditionally characterizes general practice. Furthermore, taskification is discussed in relation to challenges in general practice and international policy developments, which illustrate that taskification, while aimed at reducing workloads, often adds new pressures through supervision, \"rescue\" work, and the complexity of care, ultimately risking burnout and reduced efficiency. We conclude that while taskification offers potential solutions to workforce challenges in general practice, it risks unintended consequences such as care fragmentation, increased workload pressures, and compromised patient safety. A nuanced approach with adequate training, supervision, and protection of GP time is suggested to ensure these strategies benefit healthcare systems, practitioners, and patients.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"120-124"},"PeriodicalIF":2.7,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145549492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How state language access policies and communications mediate access to critical healthcare information.","authors":"Carolyn J Heinrich, Sayil Camacho, Mary-Margaret McGowan, Montrell Sanders","doi":"10.1177/13558196261438972","DOIUrl":"https://doi.org/10.1177/13558196261438972","url":null,"abstract":"<p><p>ObjectivesTo examine the role of state language access policies and state agency communications practices in facilitating access to vaccine information for Limited English Proficient (LEP) populations in the U.S.MethodsState language access policy data were linked to audit study field experiment data documenting the experiences (<i>n</i> = 455) of individuals of differing racial/ethnic identities and language use interacting with state health agencies to access COVID-19 vaccinations in the 50 states and District of Columbia. Regression analyses investigate whether state language access policies are associated with these outcomes: access to translation or interpretation, state health agency use of recommended communication practices, and receipt of information on how to access the vaccine.ResultsGovernment agency requirements for language access were associated with 17% higher availability of translation and interpretation services and greater use of recommended communications practices by state agencies. The use of nudges and absence of racialized or judgmental language in communications increased receipt of vaccine information by 13-26%. Interpretation was lacking in more than 40% of Spanish-language speaker phone encounters with state agencies.ConclusionsLEP populations are among the least likely to be vaccinated and disproportionately experienced negative consequences of the COVID-19 pandemic. Enacting state language access requirements and instituting training programs for health agency employees involved in vaccine distribution could help to increase vaccine access and avert some of the harmful, racialized impacts of future pandemics.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261438972"},"PeriodicalIF":2.7,"publicationDate":"2026-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147581423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What factors influence service integration and delivery by integrated neighbourhood teams operating across local health, care, and voluntary sector organisations? A rapid synthesis of qualitative evidence from the UK.","authors":"Hannah A Long, Peter Bower, Sonya Rafiq, Nicky Cullum","doi":"10.1177/13558196261437005","DOIUrl":"https://doi.org/10.1177/13558196261437005","url":null,"abstract":"<p><p>ObjectivesIntegrated neighbourhood teams (INTs) are central to health system reforms in England, aiming to deliver local, coordinated, and personalised care. Understanding the factors that influence their successful functioning is crucial for informing local policy and practice. This rapid evidence synthesis aimed to answer the research question: What factors influence service integration and delivery by INTs operating across health, care, and voluntary sector organisations?MethodsIn February 2025, we searched Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) for relevant UK-based primary research and international evidence syntheses published within the last 10 years. The database searches were complemented by searches in Google Scholar and the Google search engine. Eligible studies reported evidence on factors shaping the successful functioning of local and neighbourhood-level integrated teams. Data were rapidly synthesised qualitatively.ResultsDatabase searches identified 5139 articles (4954 after duplicates were removed). Of these, 26 were eligible for inclusion, comprising nine primary studies and 17 evidence syntheses published between 2015 and 2025. The findings were highly consistent. Key factors supporting INT functioning included a clear, shared vision; effective leadership; strong working relationships based on trust and mutual respect; clarity on interprofessional roles and responsibilities; appropriate and sustained resources and funding; opportunities for staff learning and development; co-location, dedicated time for multidisciplinary team meetings; and interoperable information technology systems to support data sharing.ConclusionsThere is strong agreement on key relational and organisational factors that support INT functioning. Our practical framework can be used to support policymakers, commissioners, and professionals when planning and implementing INTs.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"13558196261437005"},"PeriodicalIF":2.7,"publicationDate":"2026-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experiential learning from rapid evaluation in health and care.","authors":"Sonja Marjanovic, Sara Shaw","doi":"10.1177/13558196251391585","DOIUrl":"10.1177/13558196251391585","url":null,"abstract":"","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"1-3"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145345469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of family caregivers in critical illness survivor recovery at home: A qualitative study.","authors":"A Fuchsia Howard, Kelsey Lynch, Sally Thorne, Sybil Hoiss, Rakesh C Arora, Omar Ahmad, Mary T Kelly, Sarah Crowe, Allana LeBlanc, Leanne M Currie, Robert C McDermid, Richard Doll, Anita David, Brianna Hou, Alice Erchov, Gregory Haljan","doi":"10.1177/13558196251382500","DOIUrl":"10.1177/13558196251382500","url":null,"abstract":"<p><p>BackgroundWhen critical illness survivors are discharged home, they encounter a myriad of physical, emotional, cognitive, and socioeconomic challenges which can endure for an extended period of recovery. Given the extent of patient need, family members often assume the role of informal caregivers. The work inherent in this role can significantly compromise their own health, which can, in turn, influence the nature and trajectory of recovery for the survivor.PurposeThis study aimed to describe the role of informal family caregivers in patient recovery from critical illness following hospitalisation, in the context of publicly-funded healthcare and where there were no critical care follow-up or aftercare programmes.MethodsGuided by a qualitative, interpretive description approach, in-depth semi-structured interviews were conducted with 25 family caregivers of patients recovering from critical illness at home. In total, 29 interviews were conducted: 21 caregivers were interviewed once, and 4 caregivers were interviewed twice. Interview data were analyzed thematically using inductive, constant comparative methods.ResultsThe nature of family caregiving was grounded in the patient's condition, whether it involved slow recovery vs stagnation or decline, and the caregiver's capacity to engage in care. Caregivers influenced patient recovery by (1) assuming daily living and physical care responsibilities; (2) providing motivational and emotional support; (3) searching for and gathering information; (4) monitoring and supervising health and treatment; and (5) managing medical appointments and advocating for resources.ConclusionsFamily caregivers fulfilled a central role in managing a wide range of needs of survivors, found to be pivotal for their recovery. Policy and practical support are needed to help caregivers fulfil this role alongside meeting their own personal challenges and responsibilities.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":"31 1","pages":"34-45"},"PeriodicalIF":2.2,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating patient characteristics and trends of avoidable emergency department visits: Informing community health services to reduce emergency department utilization.","authors":"Ryan P Strum, Andrew P Costa, Brent McLeod, Ravi Sivakumaran, Shawn Mondoux","doi":"10.1177/13558196251358761","DOIUrl":"10.1177/13558196251358761","url":null,"abstract":"<p><p>BackgroundThere is a growing debate on whether avoidable emergency department (ED) visits, those involving health issues that could have been managed in community settings, represent a significant workload for the department. Until recently an ED physician-validated measure of avoidable visits has not been available, hindering our understanding of these patients, services rendered in the ED and the nature of their conditions. We examined patient characteristics of ED visits retrospectively classified as avoidable and potentially avoidable at a Canadian academic hospital.MethodsWe conducted a retrospective cohort study using administrative ED data from an academic hospital in Hamilton, Canada from April 1, 2018 to August 31, 2023. We categorized all ED visits as avoidable, potentially avoidable, and not avoidable using the Emergency Department Avoidability Classification (EDAC). For each class, we analyzed patient characteristics and the top five physician interventions and diagnoses. We applied linear regression, locally weighted scatterplot smoothing (LOWESS) regression, and statistical process methods to examine monthly trends in avoidable and potentially avoidable visits. Additionally, we reported annual totals and length of stay for patients transported to the ED by paramedics.ResultsOverall, 58,528 (29.0%) of 201,741 ED visits were classified as either avoidable (11,302; 5.6%) or potentially avoidable (47,226; 23.4%). These patients were predominantly young-to-middle aged, with average visit durations of 3 hours 33 minutes (avoidable) and 4 hours 26 minutes (potentially avoidable). Their primary interventions were predominantly diagnostic imaging, skin repairs and mental health assessments. The proportion of ED visits in the study period that were avoidable increased from 2.1% to 7.7% and potentially avoidable from 18.2% to 21.2%. Approximately one-in-five paramedic transported patients were classified as having either an avoidable or potentially avoidable ED visit. Transported patients had an average length of stay of 4 hours 22 minutes for avoidable visits and 4 hours 35 minutes for potentially avoidable visits.ConclusionsA notable rise in the proportion of ED visits that could have been managed in non-ED settings was observed. Providing community clinicians with resources and capacity to manage and refer patients for diagnostic imaging, skin repairs and mental health assessments may reduce avoidable ED attendance. Further exploration of avoidable ED visits transported by paramedics could support refining ED diversion care models. Hospitals and health service policymakers could benefit from similar analyses using validated measures to identify care gaps that inform the development of new health services and models tailored to the specific needs of their communities.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"5-13"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges, benefits, and strategies for delivering pregnancy care to people with disabilities: A qualitative study of service providers and decision-makers in Ontario, Canada.","authors":"Lesley A Tarasoff, Yona Lunsky, Keat Welsh, Laurie Proulx, Meredith Evans, Susan M Havercamp, Simone N Vigod, Hilary K Brown","doi":"10.1177/13558196251376146","DOIUrl":"10.1177/13558196251376146","url":null,"abstract":"<p><p>ObjectivesTo (1) understand the challenges and benefits of providing pregnancy care to people with disabilities and (2) identify strategies to address challenges, from the perspectives of health care and social service providers and decision-makers.MethodsWe undertook a qualitative descriptive study in Ontario, Canada, of 31 health care and social service providers and decision-makers. Participants completed semi-structured interviews about their education, training, and clinical or administrative experience working with pregnant and/or parenting people with physical, sensory, and intellectual or developmental disabilities, including challenges and benefits in pregnancy care provision, programming, and policies, as well as their recommendations to improve care. We took a directed content analysis approach.ResultsParticipants identified challenges in providing pregnancy care to people with disabilities, including a lack of data to inform care, the influence of social determinants of health on disabled people's lives, inadequate infrastructure, poor coordination and communication across services, minimal disability-related training, and ableist attitudes among providers. Benefits to providing pregnancy care for people with disabilities included becoming advocates for system-level change, personal fulfillment, opportunities to confront one's own biases, and development of humility related to the expertise of people with disabilities. Reflecting on these challenges and benefits, participants identified strategies for improving care, through creative resource-sharing solutions, accessibility measures, interprofessional and coordinated care, enhanced provider training, and respectful care approaches.ConclusionsFindings show the need for changes at system, institutional, and service provider levels to improve pregnancy care for people with disabilities.</p>","PeriodicalId":15953,"journal":{"name":"Journal of Health Services Research & Policy","volume":" ","pages":"14-24"},"PeriodicalIF":2.7,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12647371/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}