Jane Melton

Achieving Evidence-Based Practice: A Process of Continuing Education Through Practitioner-Academic Partnership

SUMMARY Occupational therapy is required to deliver and generate evidence-based practice. As currently articulated, evidence-based practice requires particular skills and takes time and is rarely realized. This paper illustrates a collaborative approach to building an evidence based training program within a practice context. The aim of the training program was to enable therapists in a large mental health setting to engage in evidence-based practice. Specifically, the partnership between the United Kingdom Centre for Outcomes Research and Education (UK CORE) and Gloucestershire Partnership NHS Trust (GPT) will be described. This article describes the GPT/UKCORE partnership, the process of building an evidence-based practice training program, the final structure of the evidence-based practice training program, and the evaluation of the evidence-based practice training program.

The Individual Practice Development Theory: an individually focused practice development theory that helps target practice development resources

Background  Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost-effectiveness. Objectives  This paper presents a research-based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently. Methods  The in-depth qualitative, multi-method realistic evaluation was of a multifaceted, organization-wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi-structured interviews, practice observation and documentation audit were used to gather data from occupational therapists. Findings  Results indicated that environmental contexts, particularly the support of the immediate team, and the participants personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know-how and Channelling Time. Four stages of PD characterized as: ‘In the Hangar’, ‘On the Runway’, ‘Take-off’ and ‘In the Air’ were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms. Discussion  The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support. Conclusion  With a systematic and individualized approach to PD in health care, more target PD supports can be put in place.

From Graduate to Reflective Practice Scholar

The National Health Service is currently striving to deliver evidence-based, effective and efficient services. In this climate, it is important to enable new graduates to develop their knowledge, skills and confidence to meet these exacting demands, in an effective and supportive environment. This is of particular importance because there is growing concern over the retention of new graduates. If new graduates do not receive effective support to complete the transition to a competent professional, then the concern is that they may choose to leave the profession and/or seek new roles. This opinion piece argues for an academic/practice partnership to provide the needed support structures to allow graduates to become competent professionals. Two examples are provided, which embrace such partnership working.

Program Redesign Based on the Model of Human Occupation: Inpatient Services for People Experiencing Acute Mental Illness in the UK

This paper discusses the current context of the UK mental health service system and the resulting need for program change within acute-care inpatient hospitals. The primary focus is to illustrate through practice example what can be done to support the delivery of client treatment packages by using the concepts described by the Model of Human Occupation (MOHO). The paper concentrates on explaining how MOHO has helped to guide program redesign and develop an Occupational Therapy Care Pathway to support occupation-focused services. The example given is of a hospital service in Gloucestershire, England, which provides inpatient care for people experiencing acute mental illness.

The Theoretical Principles of Management in Relation to Health Care Provision: An Analysis

Management structures in the National Health Service (NHS) have become flattened in recent years. There is, therefore, a greater responsibility placed on practitioners to carry out management tasks within their work. This article considers the NHS as an organisation and makes reference to its history, hierarchy and place in society. It describes and analyses set principles of management, drawing on various components of each school of thought. Within the discussion, proposals are made regarding working practices for those carrying out management duties within the NHS.

Managing Quality in Services for People with Learning Disabilities

tricts attempt to try to cope as best as it could with the resource problem it faced. It could be argued that existing housing arrangements for people with disabilities continue to be only partial, as described by Chesson and Sutherland (1993). What is certain is that the resource crisis faced by many local authorities will be around for some time to come. Developing effective community care policies for disabled people can only begin if local social services departments and local housing authorities attempt to work together on this issue, as this district attempted to do, rather than passing the buck between departments.