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O'cathain A. - One of the best experts on this subject based on the ideXlab platform.
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Evaluating alcohol intoxication management services: the EDARA mixed-methods study
'National Institute for Health Research', 2020Co-Authors: Moore S., Allen D., Amos Y., Blake J., Brennan A., Buykx P., Goodacre S., Gray L., Irving A., O'cathain A.Abstract:Background: Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to divert the intoxicated away from emergency care. Objectives: To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives. Methods: This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services. Results: Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients diverted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse Practitioner services, with only the latter providing evidence for diversion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to Practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery. Limitations: The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services. Conclusions: Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for diversion have not been entirely realised. The nurse-led Model was the most expensive service evaluated but was also the most likely to divert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit. Future work: Research could be undertaken to determine if a standardised Model of alcohol intoxication management services, based on the nurse Practitioner Model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication. Trial registration: Current Controlled Trials ISRCTN63096364
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Evaluating alcohol intoxication management services: the EDARA mixed-methods study
'National Institute for Health Research', 2020Co-Authors: Moore S. C., Allen D., Amos Y., Blake J., Brennan A., Buykx P., Goodacre S., Gray L., Irving A., O'cathain A.Abstract:Background Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to divert the intoxicated away from emergency care. Objectives To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives. Methods This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services. Results Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients diverted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse Practitioner services, with only the latter providing evidence for diversion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to Practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery. Limitations The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services. Conclusions Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for diversion have not been entirely realised. The nurse-led Model was the most expensive service evaluated but was also the most likely to divert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit. Future work Research could be undertaken to determine if a standardised Model of alcohol intoxication management services, based on the nurse Practitioner Model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication
Sarah Corrie - One of the best experts on this subject based on the ideXlab platform.
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the modern scientist Practitioner a guide to practice in psychology
2007Co-Authors: David A Lane, Sarah CorrieAbstract:Lunt, Foreword. Introduction, What Does it Mean to be a Scientist-Practitioner? Working Towards a New Vision. Acquiring the Art of Reasoning: Straddling the Worlds of Rigour and Meaning. Arriving at Shared Psychological Narratives: Formulation and Explanation. Innovation and Improvization: The Unacknowledged World of the Creative Scientist-Practitioner. What Kind of Scientists Are We? Re-examining the Nature of Scientific Knowledge. Developing an Identity as a Scientist-Practitioner: Defining Who we Are. Miller, Frederickson, Generalizable Findings and Idiographic Problems: Struggles and Successes for Educational Psychologists as Scientist-Practitioners. Bury, Strauss, The Scientist-Practitioner in a Counselling Psychology Setting. Haarbosch, Newey, Feeling One's Way in the Dark: Applying the Scientist-Practitioner Model in an Emerging Field. Cavanagh, Grant, Coaching Psychology and the Scientist-Practitioner Model. Kwaitowski, Winter, Roots, Relativity and Realism: The Occupational Psychologist as Scientist-Practitioner. Bono, The Scientist-Practitioner as Thinker: A Comment on Judgement and Design. Learning for Tomorrow: Professional Survival in an Uncertain World. Conclusion: The Scientist-Practitioner Model: A New Vision.
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therapists beliefs about research and the scientist Practitioner Model in an evidence based health care climate a qualitative study
British Journal of Medical Psychology, 2001Co-Authors: Sarah Corrie, M CallananAbstract:: The growing emphasis on achieving therapeutic practice that is informed by research evidence or 'evidence-based' has been well documented. However, if therapists are to operate effectively within evidence-based services, it is necessary to develop a better understanding of factors that influence their attitudes towards research in routine clinical work. Within this context, there is a need to re-examine the scientist-Practitioner Model as potentially complementing or competing with evidence-based practice. This study explores the beliefs about research and the scientist-Practitioner Model amongst a diverse group of therapists whose work is contextualized by evidence-based practice. In-depth, qualitative interviews were used to elicit significant themes that related to current practices, previous training and contact with other professionals. The findings suggest that the therapists' beliefs were shaped by different levels of influence that range from personal values to organizational and political issues. The results also highlighted how the therapists had constructed more idiosyncratic definitions of the scientist-Practitioner Model that related to perceptions of its value. Implications for further research, training and practice are discussed.
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special section counselling psychology a review of the scientist Practitioner Model reflections on its potential contribution to counselling psychology within the context of current health care trends
British Journal of Medical Psychology, 2000Co-Authors: Sarah Corrie, Margie M CallahanAbstract:Recent legislative changes in the National Health Service have resulted in the need to develop practices that are ‘evidence-based’. The move away from opinion and experience in therapeutic decision-making towards use of research in service planning poses challenges to the identity, activities and roles of counselling psychologists. This highlights the need for a clearly articulated framework of professional activity to protect and enhance the future of the profession. The scientist-Practitioner Model is one such framework and despite its contentious history, it is argued that the difficulties traditionally associated with its implementation are largely owing to an outdated view of scientific activity which relies on a positivist philosophy of science. These themes are developed by exploring the historical context in which the scientist-Practitioner Model evolved and by drawing upon psychological Models of identity, change and loss. A more contemporary meta-theoretical construction of science and scientific activity is also explored which offers a reformulation of the scientist-Practitioner Model that could complement the quest for evidence-based practice and is consistent with the philosophical underpinnings of counselling psychology. Critical questions for future research in this area are identified.
Susan Van Cleve - One of the best experts on this subject based on the ideXlab platform.
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the integration of developmental behavioral and mental health care into pediatric primary care using a nurse Practitioner Model
Pediatrics, 2018Co-Authors: Elizabeth Hawkinswalsh, Susan Van CleveAbstract:Pediatric primary care practices struggle with meeting the needs of young children who have developmental, behavioral and mental health concerns or conditions (Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health, American Academy of Pediatrics, 2009). The current and projected national shortage of child and adolescent psychiatrists and the scarcity of other pediatric mental health professionals makes access to mental health increasingly difficult for Primary Care Providers (PCPs) and families (Thomas & Holzer, 2006). The …
Elizabeth Hawkinswalsh - One of the best experts on this subject based on the ideXlab platform.
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the integration of developmental behavioral and mental health care into pediatric primary care using a nurse Practitioner Model
Pediatrics, 2018Co-Authors: Elizabeth Hawkinswalsh, Susan Van CleveAbstract:Pediatric primary care practices struggle with meeting the needs of young children who have developmental, behavioral and mental health concerns or conditions (Committee on Psychosocial Aspects of Child and Family Health and Task Force on Mental Health, American Academy of Pediatrics, 2009). The current and projected national shortage of child and adolescent psychiatrists and the scarcity of other pediatric mental health professionals makes access to mental health increasingly difficult for Primary Care Providers (PCPs) and families (Thomas & Holzer, 2006). The …
Margie M Callahan - One of the best experts on this subject based on the ideXlab platform.
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special section counselling psychology a review of the scientist Practitioner Model reflections on its potential contribution to counselling psychology within the context of current health care trends
British Journal of Medical Psychology, 2000Co-Authors: Sarah Corrie, Margie M CallahanAbstract:Recent legislative changes in the National Health Service have resulted in the need to develop practices that are ‘evidence-based’. The move away from opinion and experience in therapeutic decision-making towards use of research in service planning poses challenges to the identity, activities and roles of counselling psychologists. This highlights the need for a clearly articulated framework of professional activity to protect and enhance the future of the profession. The scientist-Practitioner Model is one such framework and despite its contentious history, it is argued that the difficulties traditionally associated with its implementation are largely owing to an outdated view of scientific activity which relies on a positivist philosophy of science. These themes are developed by exploring the historical context in which the scientist-Practitioner Model evolved and by drawing upon psychological Models of identity, change and loss. A more contemporary meta-theoretical construction of science and scientific activity is also explored which offers a reformulation of the scientist-Practitioner Model that could complement the quest for evidence-based practice and is consistent with the philosophical underpinnings of counselling psychology. Critical questions for future research in this area are identified.