Service User Expectations Research Articles

Co-Creating Descriptors and a Definition for Person-Centred Coordinated Health Care: An Action Research Study.

The aim of this study was to co-create a definition and generic descriptors for person-centred coordinated care for Ireland generated from service users’ narratives. An overarching action research approach was used to engage and empower people to tangibly impact health policy and practice. Through focus groups and a qualitative survey, primary data were collected from a national sample of health services users, caregivers and health care service users’ representative groups. Thematic analysis was used to analyse the data. Three major themes were co-produced as essential care elements. These were: ‘My experience of healthcare’, ‘Care that I am confident in’ and ‘My journey through healthcare’. Through an IPPOSI partner project steering group and their membership groups’ contribution, these themes were further refined into a definition of person-centred coordinated care and nineteen related generic descriptors. Key findings demonstrate that within complex, fragmented healthcare systems, the subjective expectations of service users should be integrated into care delivery, with a scaffolding of services to meet service users’ needs between care settings and disciplines and over time.

Z Factor: Drama as a tool to tackle mental health stigma: study design and protocol for community and public engagement in rural Zimbabwe

Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group’s composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Conclusions: Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.

Z Factor: Drama as a tool to tackle mental health stigma: study design and protocol for community and public engagement in rural Zimbabwe.

Background: Mental health is slowly gaining global significance as a key health issue, yet the stigma attached to psychosis is still a major problem. There has been little in-depth exploration of sustainable, cost-effective, and replicable community engagement strategies that address mental health myths and stigma, which are major barriers to early health-seeking behaviours. In low-income countries such as Zimbabwe, cultural and spiritual beliefs are at the centre of most mental health explanatory models, perpetuating an environment where mental health conversations are a cultural taboo. Mental health interventions should be accompanied by creative, evidence-based community engagement, ensuring that interventions are suitable for local settings and giving communities a voice in directing their health initiatives. Methods: Z Factor aimed to engage young adults and their support networks across a variety of socioeconomic groups in a rural district of Zimbabwe through their participation in an inter-ward five-staged drama competition. The focus was on psychosis, with subcategories of initial presentation/detection, seeking help/pathway to care, and the road to recovery/treatment. Each drama group's composition included a young adult and a typical support network seeking treatment from the service provider of choice. Dramas were to act as discussion starters, paving the way toward broader and deeper psychosis treatment discussions among rural communities and gaining insight into service user expectations from health research. Conclusions: Outcomes of the pilot community engagement project will be instrumental in improving understanding community perceptions about psychosis treatment and recovery in rural Zimbabwe and increasing community awareness about psychosis, as well as paving the way for initiating service provider collaboration to promote early detection and encouraging early health-seeking behaviours. The above outcomes will also inform the design of models for more responsive community and public engagement initiatives in similar low resource settings in Zimbabwe and beyond.

'Triadic' shared decision making in mental health: Experiences and expectations of service users, caregivers and clinicians in Germany.

BackgroundShared decision making (SDM) in mental health may contribute to greater patient satisfaction and is sometimes associated with better health outcomes. Here, SDM should not only involve service users and clinicians but also involve the service users' caregivers.AimThis study aimed to achieve better insight into the current SDM patterns of triads of service users, caregivers and clinicians in inpatient mental health care and the three parties' expectations towards the prospects of triadic SDM.DesignThe current research uses data from a representative cross‐sectional study on caregivers in psychiatric inpatient treatment. We analysed data on n = 94 triads of service users, their caregivers and their clinicians.ResultsAll three parties acknowledge caregivers to be of great support to monitor the progress with mental disease. The caregiver's role during consultations is most often described as being an expert, receiving or providing information and supporting service users. However, caregivers at times try to seek support for themselves during caregiver‐clinician interaction, or their behaviour was described as unhelpful. The potential prospects of caregiver involvement are clearly acknowledged despite the low implementation of caregiver involvement in this sample (only in one‐third of the cases).ConclusionTriadic SDM rarely takes place in routine inpatient care. First, there should be a focus on interventions aiming at inviting caregivers to consultations. Only in the second step should a better conceptualisation of triadic SDM be undertaken.Public ContributionEarly results were discussed with a local peer support group for caregivers of individuals living with mental illness.

The ‘branding’ of IAPT and private cognitive behaviour therapy services in England

Abstract Over the past decade, provision of cognitive behaviour therapy has expanded massively in the UK, both within the private sector and through the Improving Access to Psychological Therapies (IAPT) programme. Our aim in this study was to explore and compare the brand names adopted by IAPT and private CBT services. We obtained the names of all the IAPT and private services in England and created a word cloud for each sector. There was no significant difference in the proportion of services that adopted a brand name (72% of IAPT services vs 67% of the private services). In those with a brand name, IAPT services were significantly more likely than private services to contain positive words, and to have a theme of togetherness and collaboration. However, private services were more likely to include a psychological therapy in their name and have a theme of efficacy compared with IAPT. The most common keywords in IAPT services were ‘talking’ and ‘thinking’. IAPT services use a variety of euphemisms such as ‘talking’ for a psychological therapy. There is no theme for ‘doing’ in the IAPT or private services, despite behavioural interventions being one of the most common therapeutic components. The brand names in IAPT are overwhelmingly positive and convey the hope of a good outcome. They do not include the experience of difficult emotions, such as sadness and fear during therapy. We found just one private service that evoked the history of CBT named after Vic Meyer. Perhaps we will have some Clark and Layard centres in the years to come! Key learning aims After reading this paper, the reader should: (1) Recognise the importance of a brand name in shaping service user expectations. (2) Understand the differences between how private CBT and IAPT services present themselves to the public. (3) Recognise the omission of words conveying an active ‘doing’ theme in IAPT and private CBT service names.

Analysis of Passenger Commuter Train Services Surabaya – Sidoarjo

This study is intended to measure the level of satisfaction and expectations of service users on the Surabaya - Sidoarjo Commuter Train service with the benchmarks used, namely the Minimum Service Standard Ministerial Transportation Degree number PM 65 of 2019. The study was conducted by conducting a field survey of the condition of railway infrastructure. The survey stated preference for the Surabaya - Sidorajo commuter train users through a questionnaire. The method to be used is Importance Performance Analysis (IPA). The results of the analysis using the IPA method are expected to identify the level of satisfaction and expectations of service users on the Surabaya - Sidoarjo Commuter train service and will be able to provide service improvement suggestions to PT. Kereta Api Indonesia (KAI) as a commuter transport operator in the Gerbang Kertasusila area. In this case the research is in line with the Technology Readiness Level (TKT) point 9 which has criteria, namely the real application (application) of technology in its final form and under the intended (planned) conditions as in operational testing and evaluation. In general, this is the last part / aspect of the bug fixing effort in actual system development. Examples include for example the use of the system in operational mission conditions.

THE ROLE OF WORK MOTIVATION TO IMPROVE QUALITY OF GOVERNMENT SERVICES

Quality of service is the superiority of services provided by a person or service provider to meet the needs and expectations of service users. Service quality indicators used to measure it are Manifestation, reliability, responsiveness, assurance, and empathy. This research uses a quantitative design approach to answer the problem formulation and proof of the research hypothesis. The study aims to analyze the influence of exogenous variables, namely transformational leadership, competence, and work environment on endogenous variables, namely service quality through intervening variables, namely work motivation. The conceptual framework of the research underlies the submission of the research hypotheses. Measurement instruments are given to the sample to obtain research variable data. Research data were analyzed using Structural Equation Modeling (SEM) to test hypotheses. This study uses a correlational research survey design. This study's population is the apparatus (employees) in the Regional Government of Tuban Regency as many as 155. The results of this study are as follows: Transformational Leadership, Competence, and Work Environment have a significant effect on the Work Motivation of the Tuban Regency Regional Government Apparatus. Transformational Leadership, Competence, and Work Environment have a significant effect on the Service Quality of the Tuban District Government Apparatus Services. Work Motivation has a significant effect on the Service Quality of the Tuban Regency Regional Government Apparatus. Transformational Leadership, Competence, and Work Environment have a significant effect on the Service Quality of the Tuban Regency Government Apparatus through Work Motivation.

Quality of Functional Services for Private University Lecturers (Studies at the Office of LLDIKTI Region VIII)

Abstract Public opinion regarding the quality of public organization services is an interesting issue in recent years, especially after the many complaints from the public that states that it is not as expected by the community. One of the services available at the LLDIKTI office is the management of functional Lecturer and other functional staff. The purpose of this study was to determine the quality of management services of functional position, determine the suitability of service user expectations with the performance of functional position management services and determine priority policies that can be applied in improving the quality of functional position management services in LLDIKTI Region VIII. The number of samples from the population determined by the Krejcie and Morgan table was 357 people. The data analysis technique used is the validity test, reliability test, calculating the value of the community satisfaction survey (SKM), and the Importance Performance Analysis (IPA) Analysis. The results of this study shows the level of satisfaction using the community satisfaction survey (SKM) included in the quality of service B with a score of 82.24 with the GOOD category. Conformity level is the average of the score of the implementation level and the average score of the importance level is 93.89%. Based on the results of the Cartesian diagram, the element of service quality that needs to be prioritized for improvement in its implementation is the element of item suitability with the type of service, clarity of flow in service procedures and clarity of information about service procedures. Suggestions that can be given are an increase in the clarity of information on the management of functional positions can be done by increasing the use of the web and the user data-based notification system

Patient centred care in diagnostic radiography (Part 1): Perceptions of service users and service deliverers

IntroductionThere is growing awareness of the importance of patient centered care (PCC) in health care. Within Radiography in the UK, elements of PCC are embedded within professional body publications and guidance documents. However, there is limited research evidence exploring whether perceptions of PCC are equivalent between those delivering (radiographers) and those experiencing (patient) care. This study aimed to address this gap by determining compatibility in perceptions of PCC between those using and those delivering radiography services. This is the first step in developing measurable indicators of PCC in diagnostic radiography. MethodsA multi-method two stage approach was undertaken using survey and interview data collection techniques. Ethical approval was granted by University of Derby College of Health & Social Care Ethics committee. This paper reports Stage 1 of the study, the online, cross sectional survey. Participants were asked to indicate their level of agreement to a series of attitudinal statements using a 5-point Likert scale. Statements were paired, but not co-located to increase validity. Participants were invited to provide free text comments to supplement their responses. Stage 2 of the project is reported separately. ResultsSurvey responses were received from all 3 participant subgroups. A minimum response rate of 30 participants per sub-group was set as a target. Response rates varied across subgroups, with only radiography managers failing to meet the expected response threshold. Wide disparity between perceptions of service users and those delivering radiography services on what constitutes high quality PCC was evident. ConclusionIt is evident that there is still work required to ensure parity between expectations of service users and deliverers on what constitutes high quality PCC. Implications for practiceFurther work is required to identify measurable service delivery outcomes that represent PCC within radiographic practice.

Developing a Hypothetical Implementation Framework of Expectations for Monitoring Early Signs of Psychosis Relapse Using a Mobile App: Qualitative Study.

BackgroundRelapse is a common experience for people diagnosed with psychosis, which is associated with increased service costs and profound personal and familial distress. EMPOWER (Early signs Monitoring to Prevent relapse in psychosis and prOmote Well-being, Engagement, and Recovery) is a peer worker–supported digital intervention that aims to enable service users to self-monitor their mental health with the aim of encouraging self-management and the shared use of personal data to promote relapse prevention. Digital interventions have not been widely used in relapse prevention and, therefore, little is currently known about their likely implementation—both within trials and beyond.ObjectiveSeeking the perspectives of all relevant stakeholder groups is recommended in developing theories about implementation because this can reveal important group differences in understandings and assumptions about whether and for whom the intervention is expected to work. However, the majority of intervention implementation research has been retrospective. This study aimed to discover and theoretically frame implementation expectations in advance of testing and synthesize these data into a framework.MethodsTo develop a hypothetical implementation framework, 149 mental health professionals, carers, and people diagnosed with psychosis participated in 25 focus groups in both Australia and the United Kingdom. An interview schedule informed by the normalization process theory was used to explore stakeholders’ expectations about the implementation of the EMPOWER intervention. Data were analyzed using thematic analysis and then theoretically framed using the Medical Research Council guidelines for understanding the implementation of complex interventions.ResultsAll groups expected that EMPOWER could be successfully implemented if the intervention generated data that were meaningful to mental health staff, carers, and service users within their unique roles. However, there were key differences between staff, carers, and service users about what facilitators and barriers that stakeholders believe exist for intervention implementation in both the cluster randomized controlled trial stage and beyond. For example, service user expectations mostly clustered around subjective user experiences, whereas staff and carers spoke more about the impact upon staff interactions with service users.ConclusionsA hypothetical implementation framework synthesized from stakeholder implementation expectations provides an opportunity to compare actual implementation data gathered during an ongoing clinical trial, giving valuable insights into the accuracy of these stakeholders’ previous expectations. This is among the first studies to assess and record implementation expectations for a newly developed digital intervention for psychosis in advance of testing in a clinical trial.Trial RegistrationISRCTN Registry ISRCTN99559262; http://www.isrctn.com/ISRCTN99559262

Promoting the delivery of integrated care by a tiered approach of training and education

The drive for integration has resulted in a change in the workforce, their pattern of delivery and their hopes and also enhanced service user's expectations. To accommodate for these changes in the health care arena there is an enhanced need for education and training around the sphere of integration. A combined training and educational approach was utilised to service the needs of the care community to upskill the practitioners and individuals involved in the various services working in the integrated and not as yet integrated arenas. Examples of this training and educational approach included offering all pre registration students including all fields of nursing, paramedics, physiotherapists and social work students being offered the opportunity to attend themed days around integration. Short (8 day and 6 day) courses were offered to practitioners from all disciplines and in both primary and secondary care. These courses ranged from non assessed to degree and master's level around pertinent topics to the practitioners including change management and transformative leadership in the integrated arena. The highlights were significant including meaningful positive feedback and changes to enhance person centred care in a variety of arenas and levels of care. Examples included improving referral systems, shadowing between disciplines, reviewing record keeping and improved co-ordination between services upon service user discharge. This innovative and inter connected educational and training approach had a fundamental impact on service delivery, raised practitoners feelings of confidence around the field of integrative delivery and resulted in a raft of improvements to person centred care both to individuals and for whole areas of care. The transferability of such programmes is certaintly possible and can definitely be replicated and the potential for improving person centred care in the integrated care arena has certaintly been demonstrated. Signficant beneftis have been noted including positive feedback from the individuals involved in the programmes and from the service users themselves. There has been an increased number of integrated projects and developments commenced often being initiated by practitioners themselves supported by their employing organisation and the educational department. Initiating, creating and changing the format of education and training around the integrated arena to lead the way and accomodate need has been initially, heavily time intensive and has required new ways of working and thinking. However, it has resulted in a change of ethos, signficant improvement in the level of service and enhancing the knoweldge base of practioners in the arenas of integrated care. Such a concerted programme is transferable and replicable although it requires support including funding and time although it can be tailored specifically to fit the area of care. There has been expected and unexpected benefits from such action and it has certaintly resulted in an increased standard of person centred care being offered, all the stakeholders report the level of knowlege around integration and its benefits has increased and the development of an increased number of integrated projects has been phenomenal.

KEPUASAN PENGGUNA DITINJAU DARI KREDIBILITAS STAF LAYANAN DI PERPUSTAKAAN DAN PUSAT INFORMASI ILMIAH FAKULTAS EKONOMI UNPAD

Abstract. The purpose of study was to determine user satisfaction toward credibility of staff library service at Library and Scientific Information Center at Economics and Business Faculty, University of Padjadjaran (FEB UNPAD). The research of library staff's credibility based on perceptions and expectations (minimum and maximum expectations). There are three components to measure in this study:(1)Trustworthiness, (2) Expertise, and (3) Fascination. The population in this study is determined based on the number of users who come to the P2I2 of FEB UNPAD. Sampling technique that used in this study is Purposive Sampling with 99 people as sample. Data was collected by questionnaire, conduct observation, and literature study. The results showed that overall users are coming to the P2I2 of FEB UNPAD were satisfied with the services. This user satisfaction based on the gap (gap) between the perceptions and expectations of service users indicates that the P2I2 of FEB UNPAD has good credibility and is in " zone of tolerance ", in other words the services provided by library's staff at Faculty of Economics and Business, Padjadjaran University, has meet the user's expectations.

Implementing high-quality care for people with complex needs

Olan Ajayi outlines the pressures on care providers who must meet the expectations of service users, their families and the regulators

What do service users want and who cares?

The NHS Constitution ( Department of Health (DH), 2013a ) sets out the principles and values of the NHS in England: care should be planned and provided in partnership with service users and their families and this patient-focused approach should be of a consistently high quality with respect, dignity, compassion and care as core values. The newly updated Code ( Nursing and Midwifery Council (NMC), 2015 ) concurs with this philosophy by stating the interests of service users must come first by ensuring their privacy, dignity and confidentiality are preserved and their needs are recognised, assessed and met. Furthermore, the introduction of revalidation ( NMC, 2015 ) to replace the post-registration education and practice (Prep) standards ( NMC, 2011 ) includes the requirement for midwives to demonstrate to the NMC on a regular basis that they continue to remain fit to practise. This will, in part, be evidenced by written reflective accounts, based on the requirements of the Code, using feedback from service users, patients, relatives, colleagues and others ( NMC, 2015 ). This article will provide a definition of a service user in the context of maternity services and outline current policy and professional body requirements in relation to service user involvement in care. It will assess the literature with regards to service user expectations of ‘a good midwife’ and the Friends and Family Test (FFT) ( NHS England, 2015 ) to consider the relationship between policy, practice and service user experiences and expectations.

Understanding the Service Quality Perception Gaps between Judicial Servants and Judiciary Users

Judiciary service user expectations are usually not the same as ideas harbored in the minds of civil servants delivering such services. This discrepancy matches the definition of the service delivery GAP 1, as identified and assessed by SERVQUAL (Service Quality), a tool that for almost three decades has been employed worldwide in measuring service quality in many different industries and countries, in both private and public organizations. Through participant observation, semi-structured interviews and empirical data collected by SERVQUAL, this paper focuses on assessing this service delivery GAP 1 for the Second Court of Appeal within Costa Rica’s Judicial Branch.

Increasing the employment rate for people with longer-term mental health problems

Aims and methodTo examine the effects of implementing the individual placement and support (IPS) approach within four community mental health teams (CMHTs). Demographic, clinical and vocational data were collected through a repeated cross-sectional survey. Additionally, a service user experience survey was conducted.ResultsThe IPS approach appears to have a significant effect on the employment rates of service users; a higher proportion felt able to return to employment and a smaller proportion believed they were unable to work because of their mental health problems. Employment rates for service users appear to be independent of general employment rates.Clinical implicationsImplementing IPS appears to increase the employment rates in CMHTs resulting in increased service user expectations of being able to return to work.

The need for continuous change in pathology and medical laboratory services

In most countries, pathology services have undergone a series of radical reforms, which have impacted on, moulded and manipulated the professions and the diverse set of occupational groups on which they rely. Reorganisation policies have placed considerable emphasis on the need for carefully planned change management and have highlighted the sensitive nature of stakeholder involvement in healthcare delivery of which laboratory medicine is a vital part. Approximately 70% of patient medical management decisions are based on scientific data generated within diagnostic laboratories as part of the healthcare pathway. Within the context of organisations, change presents three major problems, resistance, control, and power. Reform driven changes have led to changes in the work-based tasks and competencies of pathology staff and one strategy that healthcare providers employ to adapt to this dynamic environment is multi-skilling as part of a raft of changes aimed at reducing costs and improving performance, efficiency and competitiveness. This paper identifies the factors, which are crucial in directing the models of change which need to be adopted to deliver the most cost-effective services tailored to meet the needs of patients and the expectations of service users.

Employment Service Provider Knowledge of Service User Assistance Needs

Employment service provider knowledge of service users' assistance needs was assessed by the extent of agreement between the service users' work-related self-efficacy and ratings assigned by service providers. Thirty-two employment service user and provider pairs were recruited from 5 local disability employment services offering intensive assistance to people with psychiatric disabilities to find and keep employment. Service users and providers were interviewed separately. Matching questions enabled the service user's work-related self-efficacy to be compared with the service provider's perception of user efficacy in performing 37 core work-related tasks. Information about health status, work history, and future employment expectations were also collected. Little agreement was found between service user and provider ratings of service user efficacy. Service user ratings were negatively associated with psychological distress and positively associated with service user expectations of vocational success and the clarity of their own vocational goals. Service provider ratings were positively associated with length of contact in months, current employment, service providers' views of the clarity of users' goals, and a gender match between users and providers. The low agreement represents low service provider knowledge of service user assistance needs at the task level. Increasing provider knowledge of service user work-related efficacy may improve the tailoring of assistance to individual needs. Further investigations are now needed to test whether this promising approach can improve employment outcomes in supported employment for people with psychiatric disabilities.

Beyond Mental Health Maintenance: An Evaluation Framework Driven by Recovery-Focused Outcomes

Evaluations of mental health outcomes have traditionally focused on indicators of mental health maintenance and stability. Although many jurisdictions in Canada are incorporating the principles of recovery into mental health services, evaluation practices and accountability frameworks have not kept pace with this shift in thinking. In our local regions of Waterloo and Wellington-Dufferin, Ontario, an innovative partnership between mental health agencies and consumer organizations has developed to apply principles of recovery to system-wide case management. In this article we describe the development of a comprehensive logic model framework designed to assess the impact of system-wide changes to practice. The model is grounded in the experiences, needs, and expectations of service users. This framework positions recovery-focused outcomes as alternatives to maintenance-based outcomes and as central to knowledge development and accountability in mental health systems.

Shared Decision Making Is an Ethical Imperative

Shared Decision Making Is an Ethical Imperative