Service Stakeholder Research Articles

서비스 디자인 관점에서 본 치유농업 발전방안

Healing agriculture is attracting attention as a new industrial field that contributes to improving people's health and quality of life by utilizing the pluralistic functions of agriculture. This study suggests that the perspective and methodology of service design can be effectively applied in seeking the development direction of healing agriculture. Through a literature review and analysis of domestic and international best practices, it was confirmed that principles such as user-centeredness of service design, stakeholder participation, and use of ICT technology can contribute to the design and improvement of therapeutic agriculture programs. In addition, the development potential of healing agriculture as a 6th industry was highlighted in terms of revitalizing the local economy and creating social value. Based on the analysis results, policy and practical recommendations for revitalizing healing agriculture were derived. It was proposed that service design education be included as a mandatory part of the training process for healing agriculture professionals, that user experience indicators be reflected in the healing farm certification evaluation, and that a collaborative governance system between relevant ministries and the private sector be established. This study emphasizes that the introduction of service design is essential for the sustainable growth of healing agriculture, and suggests that in-depth research and policy support to support this are required.

Client and stakeholder perceptions of a novel, nurse practitioner-led alcohol and other drug ambulatory withdrawal service.

Despite recommendations for ambulatory withdrawal programs appearing in many contemporary alcohol and other drug treatment guidelines, to date there have been few studies exploring such programs from client and service stakeholder perspectives. The aim of this study was to explore both individual and service stakeholder perceptions of a nurse practitioner-led ambulatory withdrawal service on the Gold Coast, Queensland, Australia. Data were obtained from three groups: clinicians with knowledge of the service (n = 6); relatives of clients who had used the service (n = 2); and clients who had used the service (n = 10) using a Qualitative Descriptive design. Saldaña's (Saldaña, The coding manual for qualitative researchers. 2013) structural coding framework was used to analyse and code data into themes, with the study reported in accordance with the Consolidated Criteria for Reporting Qualitative Research (COREQ) checklist (Tong et al. Int J Qual Health Care 2017;19:349-57). Participants noted advantages of the nurse practitioner-led ambulatory withdrawal service, including rapid availability of admission to the service and a person-centred approach. Compared with other ambulatory withdrawal options, clients valued the ability to remain in their own environment, however participants suggested greater follow-up after withdrawal, with the potential of a home visiting service for greater client engagement and treatment retention. Findings provide evidence to suggest that nurse practitioner-led ambulatory withdrawal services are an acceptable option for a proportion of clients who need rapid access to services when they wish to make changes to their alcohol and/or other drug use. Furthermore, they can provide person-centred care for comorbid physical and mental ill health occurring in addition to psychosocial issues associated with alcohol and/or other drug use.

Acceptability of digital vending machines to improve access to sexual and reproductive health in Brighton, UK: a qualitative analysis

IntroductionSexual health remains a public health priority and relies on widely available testing to enable prompt diagnosis and treatment. Technology-based approaches to distribute tests have potential to increase access and...

THE RESILIENCE AND RENEWAL STRATEGIES EMPLOYED BY MACAU'S SMALL BUSINESSES TO SURVIVE AND THRIVE DURING THE COVID-19 CRISIS: A COMPREHENSIVE REVIEW

The COVID-19 epidemic presented unparalleled difficulties for small enterprises on a global scale, and the small company sector in Macau was not exempt from these issues. The present research examines the resilience and renewal tactics implemented by small enterprises in Macau to endure and prosper during the COVID-19 pandemic. This study investigates the varied reactions and adaptation strategies implemented by small enterprises in Macau using qualitative research methodologies such as interviews and case studies. The results demonstrate a variety of resilience solutions, encompassing inventive business models, digitalization, product and service diversification, stakeholder collaboration, and utilisation of government support efforts. Furthermore, this study aims to address the influence of organisational culture, leadership, and staff resilience on the crisis response of small enterprises. This study enhances our comprehension of how small enterprises can effectively face unparalleled obstacles and emergemore resilient from catastrophes. The findings from this study have the potential to contribute valuable knowledge to policy interventions, support mechanisms, and capacity-building programs that seek to improve the resilience of small enterprises in Macau and other regions.

Identifying the challenges of implementing the use of statistical thinking principles and concepts for dental services organizations in the Kingdom of Saudi Arabia: A mixed survey and observational study

Introduction: Identifying obstacles that prevent the adoption and implementation of statistical techniques (STes) could enlighten policymakers’ decisions and pave the way for fostering the attainment of predetermined targets in the health-care sector, in line with Saudi Vision 2030 and the transformational period in the health-care sector, including dental services. Aims: The study aimed to identify and discuss the challenges preventing the adoption of statistical thinking (STk) and statistical techniques in dental service organizations in Saudi Arabia. Materials and Methods: The study applied a mixed design to investigate the researched case. An exploratory approach was used to obtain an initial understanding of the case, explore it, and find factual evidence of its structure, dynamics, and context. On the other hand, an explanatory approach was employed to address inquiries of the mechanisms and rationales behind a specific event. This study employs a triangulation concept, combining survey results and a comprehensive examination of charts, reports, and documentation to unravel the intricate operational performance and decision-making (DM) facets. Results and Discussion: The survey, conducted over two time points with 57 and 49 participants, revealed a positive trajectory in crucial elements, notably a two-fold improvement observed in the STk factor. The regression analysis validated these trends, revealing numerical shifts in several elements and robust model fitting. Documentation analysis, spanning 120 documents, 23 reports, and 13 interview papers, enriched our understanding of the organizational landscape. The initial identification of 208 codes was thematically refined, encapsulating diverse challenges ranging from workforce dynamics to data quality and facility management. The discussion encompasses findings on organizational efficacy, resource constraints, structural inflexibility, and challenges in managerial DM. It highlights systemic inefficiencies, unbalanced demand-support dynamics, and consequences on service quality and stakeholder satisfaction. Conclusion: The study explored the adoption of new healthcare management systems in Saudi Arabia, focusing on STk and STes integration, and highlights significant cultural advancements.

A service evaluation and stakeholder perspectives of the ‘Pharmacy Support and Development’ Service across a GP Federation

Abstract Introduction Since 2019 in England, introduction of the Additional Roles Reimbursement Scheme (ARRS), which includes pharmacists and pharmacy technicians1, has led to staggering growth in General Practice (GP) pharmacy workforce. According to workforce data, in 2017 there were 584 pharmacists and 0 pharmacy technicians in GP, and in 2021 numbers soared to 4684 and 989, respectively2. In 2022, The King’s Fund explored issues affecting implementation and integration of ARRS roles in GP and found that roles are inadequately supported and not implemented effectively3. They concluded that critical to the effective integration of ARRS roles within GP is support involving clinical supervision and peer support3. In South & East Leeds (SEL) GP Group (a GP Federation), provision of the Pharmacy Support and Development service, consisting of a Head of Clinical Pharmacy and Advanced Education & Training Pharmacist, has been in place since 2019. It aims to facilitate training and provide peer support and clinical supervision for pharmacy professionals employed across the seven Primary Care Networks (PCN), and member practices within SEL GP Group. Aim To evaluate the Pharmacy Support and Development service at SEL GP Group by assessing effectiveness of current provision through exploration of stakeholder perspectives and identifying levels of satisfaction. Methods Two digital surveys were created and sent via email to all SEL GP members (PCN managers and Clinical Directors, n=13) and all SEL GP pharmacy staff (PCN Pharmacy technicians and Pharmacists, n=37). Questions focussed on obtaining perspectives from stakeholders on current provision and seeking suggestions for improvement. Data was collected between January-February 2023. All surveys were anonymous, and participants aware of this before completing the survey. No ethical approval was required for this service evaluation involving only SEL GP employees, and this was agreed within the organisation. Results There were 8 responses (62%) from SEL GP members and 26 (70%) from SEL GP PCN pharmacy staff. For members: 88% felt the service supported retention of pharmacy ARRS staff, 63% felt the service positively influenced their decision to recruit pharmacy ARRS staff, and 88% ‘Agree’ or ‘Strongly Agree’ that offering this service is attractive to prospective employees. Overall, 88% described the service as ‘Outstanding’ or ‘Excellent’. For pharmacy staff: 96% felt the service helped them integrate as new starters, 100% agreed the service supported understanding of their role, 88% ‘Agree’ or ‘Strongly Agree’ that having this service aids recruitment of pharmacy ARRS roles, and 96% felt they receive appropriate support and supervision. Overall, 85% felt ‘Very Satisfied’ with the service. Discussion/Conclusion The findings suggest that the Pharmacy Support and Development service at SEL GP Group is favourably perceived by stakeholders and thus far, has had a positive impact on integration and continued recruitment of pharmacy ARRS staff. Questionnaires were not returned by 38% of SEL GP members and 30% of SEL GP PCN pharmacy staff, and this is a potential limitation. However, since the findings indicate that the Pharmacy Support and Development service has been instrumental to staff retention and integration into practice teams, our next steps are to consider adopting this model for non-pharmacy ARRS staff within SEL GP Group.

Non-profit crisis leadership during the COVID-19 pandemic in India and the United States

ABSTRACT During extreme crises, governments’ capacity is compromised, and they need support from non-profits, especially to reach the vulnerable and marginalised. Our qualitative study examines leadership response to the COVID-19 pandemic at four US and Indian non-profits; they paused their mission-related activities to focus on crisis leadership tasks. Our key findings reveal the importance of obtaining reliable information, balancing service delivery and stakeholder safety, communication with stakeholders, accepting the new normal and adopting creative solutions. These findings can inform training non-profit leaders on a number of key issues.

Developing a Theoretically Informed Implementation Model for Telemedicine-Delivered Medication for Opioid Use Disorder: Qualitative Study With Key Informants.

Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily affected by the opioid crisis and consequent rising mortality and morbidity rates in relation to opioid use disorder. Despite the increase in the use of TMOUD, there are no established service- and process-focused models to guide the implementation of this intervention. This study aims to develop a process- and service-focused implementation model in collaboration with key stakeholders and bring together peer-reviewed literature, practice-based knowledge, and expert opinions. The simple rules for evidence translation in complex systems framework was applied to guide the development of a 6-step qualitative study. The steps were definition of the scope and objectives of the model, identification of evidence, stakeholder engagement, draft model development, key informant consultation, and final model specification. The final specification for the TMOUD implementation model incorporated key strategic priorities, service delivery prerequisites, service design elements, stakeholder identification and engagement, key process domains, and iterative cycles of evaluation and improvement. Through stakeholder engagement and key informant consultation, we produced a process- and service-focused TMOUD implementation model. The model is modifiable to different contexts and settings while also in keeping with the current evidence base and national and international standards of high-quality opioid use disorder care.

The national health service England diabetes prevention program—A narrative review

Abstract The National Health Service (NHS) Diabetes Prevention Program (DPP) is a comprehensive initiative in the United Kingdom aimed at preventing type 2 diabetes (T2DM) among individuals with prediabetes. The NHS DPP emphasizes early intervention and underscores the potential for preventing or delaying T2DM. Currently, it operates since 2015 at 44 geographically defined sites, serving an estimated annual volume of 200,000 patients. This narrative review evaluates the NHS DPP. A literature search, adhering to the Participants, Concept, and Context review framework, was conducted in various databases and sources, limited to the period from 2015 to 2023. Data were categorized based on publication date, study type, program indicators, and focus areas, forming the framework for the review discussion. The review search yielded a total of 18,357 articles, of which 45 were included, with a predominant focus on program effectiveness. The NHS DPP demonstrates strengths in risk reduction and cost-effectiveness but faces challenges related to fidelity and the needs of diverse populations. The review highlights the importance of evidence-based service delivery, stakeholder engagement, and digital innovation in future DPP programs. While a centralized approach provides structure, local flexibility is essential to cater to population-specific needs. This review underscores the importance of strategic planning, political support, partnerships, and robust data collection in DPP implementation. It recommends targeting high-risk individuals, intensive lifestyle interventions, and embracing digital solutions for program delivery. Ongoing research, including analysis of long-term data and user perspectives, will further enhance the evidence base for DPP programs worldwide.

Advanced Timber Construction Industry: A Quantitative Review of 646 Global Design and Construction Stakeholders

There has been a multi-storey timber construction boom since the start of the millennium. While there is now a body of research on trends, benefits, and disadvantages of timber construction, there is not yet literature on the wider market or the impact of stakeholders on it. This research investigates the (i) architects, (ii) engineers, and (iii) manufacturers involved in the realization of 300 contemporary multi-storey timber buildings from an existing survey. The analysis is based on data sourced from stakeholder websites and the building survey. It evaluates the perceived level of timber expertise of stakeholders based on service categorization and stakeholder type and relates them to the buildings they worked on. The research uses quantitative methods to answer qualitative questions on the connection between architectural variety in timber construction and the stakeholders involved. Interconnectivity between stakeholders and projects is visualized in an interactive network graph. The study shows a segmented mass timber market with relatively few impactful design and construction stakeholders, mostly located in central and northern Europe. It also identifies fabricators as the largest group of innovators advancing the industry and enabling the construction of more complex projects. It reveals the importance of collaboration and knowledge sharing for the industry’s growth.

Roles of public service and private stakeholders in the 2017-2018 listeriosis epidemic in South Africa: An ethical conjecture.

The aim of this article is to carry a bioethical and a limited policy analysis on the progression and aftermath of the 2017-2018 listeriosis epidemic or disaster in South Africa. This links the context of the listeriosis epidemic/disaster to the overall public health systems, disaster medicine, and ethics in South Africa, with specific focus on standards of public service and private stakeholder conduct in the country. The public service angle is unpacked in terms the policy framework relevant to ethics and public health/disaster management. In addition, the process and ethical implications of the management, as well as the role of the various stakeholders, in the 2017-2018 listeriosis epidemic/disaster in South Africa are analyzed and reflected upon. Results of the current study indicate that actions of the public health officials and biomedical scientists, who investigated the listeriosis epidemic/disaster as public servants, were executed in line with the code of conduct of the public service in South Africa. The relevant public service legislation and ethical norms of the public service in South Africa were also adhered to. A slightly different approach was discovered in the conduct of the ready-to-eat (RTE) meat producer that had owned the factory, which was identified as the source of the listeriosis epidemic/disaster. The narrative of online resources indicates that there were many negative outcomes of the 2017-2018 listeriosis epidemic/-disaster in South Africa. Those were stories about negative outcomes of the epidemic that impacted individuals, who were listeriosis sufferers. Their voices and their stories' representation provide an important resource of data on the impacts on the complex disasters on the South African population. Novel approaches are proposed to address the challenges identified along the public-private goods continuum and approaches to food production and access to sources of dietary protein in South Africa.

Service user and stakeholder engagement in maternal and newborn health research in low- and middle-income countries: A systematic review protocol.

Service user and stakeholder engagement have been widely considered as key aspects in translating knowledge into realistic policies and practices. However, there is a paucity of accumulative evidence about service user and stakeholder engagements in maternal and newborn health (MNH) research in low- and middle-income countries (LMICs). Therefore, we aim to systematically review the existing literature that includes service user and stakeholder engagement in maternal and newborn health research in low- and middle-income countries. The design of this protocol is guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA-P) checklist. We will systematically run the search in PubMed/MEDLINE, PsycINFO, Scopus, Science Direct, and CINAHL to obtain relevant peer-reviewed literature published between January 1990 and March 2023. The list of extracted references will be screened by applying the study inclusion criteria, and eligible studies will be processed for further evaluation before being included in the review. The quality of the selected study will be assessed using the critical appraisal skills program (CASP) checklists and the Mixed Method Appraisal Tool (MMAT) checklist. A narrative synthesis will be used to synthesised results from all the included studies. To the best of our knowledge, this systematic review will be the first synthesised evidence on service user and stakeholder engagement in maternal and newborn health research in low- and middle-income countries. The study highlights the importance of service user and stakeholder roles in designing, implementing, and evaluating maternal and newborn health interventions in resource-poor settings. The evidence from this review is expected to be useful for national and international researchers/stakeholders for practising meaningful and effective ways of engaging users and stakeholders in maternal and newborn health research and related activities. The PROSPERO registration number is CRD42022314613.

Traumatic Brain Injury Intensive Evaluation and Treatment Program: Protocol for a Partnered Evaluation Initiative Mixed Methods Study.

The traumatic brain injury (TBI) Intensive Evaluation and Treatment Program (IETP) is an innovative modality for delivering evidence-based treatments in a residential, inpatient format to special operational forces service members and veterans with mild TBI. IETPs provide bundled evidence-based assessment, treatment, referral, and case management in concordance with the existing guidelines for mild TBI and commonly co-occurring comorbidities. To date, there has been no formal characterization or evaluation of the IETP to understand the determinants of implementation across the system of care. The goal of our partnered evaluation initiative (PEI) with an operational partner, the Physical Medicine and Rehabilitation National Program Office, is to facilitate the full implementation of the IETP across all 5 Veterans Health Administration TBI-Centers of Excellence (TBI-COE) and to inform minimum standards while supporting the unique characteristics of each site. This IETP partnered evaluation will describe each of the 5 TBI-COE IETP services and state of implementation to identify opportunities for adaptation and scale, characterize the relationship between patient characteristics and clinical services received, evaluate the outcomes for participants in the IETP, and inform ongoing implementation and knowledge translation efforts to support IETP expansion. In alignment with the goals of the protocol, ineffective treatment components will be targeted for deimplementation. A 3-year concurrent mixed methods evaluation using a participatory approach in collaboration with the operational partner and TBI-COE site leadership will be conducted. Qualitative observations, semistructured focus groups, and interviewing methods will be used to describe IETP, stakeholder experiences and needs, and suggestions for IETP implementation. Quantitative methods will include primary data collection from patients in the IETP at each site to characterize long-term outcomes and patient satisfaction with treatment and secondary data collection to quantitatively characterize patient-level and care system-level data. Finally, data sets will be triangulated to share data findings with partners to inform ongoing implementation efforts. Data collection began in December 2021 and is currently ongoing. The results and deliverables will inform IETP characterization, evaluation, implementation, and knowledge translation. The results of this evaluation seek to provide an understanding of the determinants affecting the implementation of IETPs. Service member, staff, and stakeholder insights will inform the state of implementation at each site, and quantitative measures will provide options for standardized outcome measures. This evaluation is expected to inform national Physical Medicine and Rehabilitation Office policies and processes and knowledge translation efforts to improve and expand the IETP. Future work may include cost evaluations and rigorous research, such as randomized controlled trials. DERR1-10.2196/44776.

Health Economics Research on Non-surgical Biomedical HIV Prevention: Identifying Gaps and Proposing a Way Forward

Although HIV prevention science has advanced over the last four decades, evidence suggests that prevention technologies do not always reach their full potential. Critical health economics evidence at appropriate decision-making junctures, particularly early in the development process, could help identify and address potential barriers to the eventual uptake of future HIV prevention products. This paper aims to identify key evidence gaps and propose health economics research priorities for the field of HIV non-surgical biomedical prevention. We used a mixed-methods approach with three distinct components: (i) three systematic literature reviews (costs and cost effectiveness, HIV transmission modelling and quantitative preference elicitation) to understand health economics evidence and gaps in the peer-reviewed literature; (ii) an online survey with researchers working in this field to capture gaps in yet-to-be published research (recently completed, ongoing and future); and (iii) a stakeholder meeting with key global and national players in HIV prevention, including experts in product development, health economics research and policy uptake, to uncover further gaps, as well as to elicit views on priorities and recommendations based on (i) and (ii). Gaps in the scope of available health economics evidence were identified. Little research has been carried out on certain key populations (e.g. transgender people and people who inject drugs) and other vulnerable groups (e.g. pregnant people and people who breastfeed). Research is also lacking on preferences of community actors who often influence or enable access to health services among priority populations. Oral pre-exposure prophylaxis, which has been rolled out in many settings, has been studied in depth. However, research on newer promising technologies, such as long-acting pre-exposure prophylaxis formulations, broadly neutralising antibodies and multipurpose prevention technologies, is lacking. Interventions focussing on reducing intravenous and vertical transmission are also understudied. A disproportionate amount of evidence on low- and middle-income countries comes from two countries (South Africa and Kenya); evidence from other countries in sub-Saharan Africa as well as other low- and middle-income countries is needed. Further, data are needed on non-facility-based service delivery modalities, integrated service delivery and ancillary services. Key methodological gaps were also identified. An emphasis on equity and representation of heterogeneous populations was lacking. Research rarely acknowledged the complex and dynamic use of prevention technologies over time. Greater efforts are needed to collect primary data, quantify uncertainty, systematically compare the full range of prevention options available, and validate pilot and modelling data once interventions are scaled up. Clarity on appropriate cost-effectiveness outcome measures and thresholds is also lacking. Lastly, research often fails to reflect policy-relevant questions and approaches. Despite a large body of health economics evidence on non-surgical biomedical HIV prevention technologies, important gaps in the scope of evidence and methodology remain. To ensure that high-quality research influences key decision-making junctures and facilitates the delivery of prevention products in a way that maximises impact, we make five broad recommendations related to: improved study design, an increased focus on service delivery, greater community and stakeholder engagement, the fostering of an active network of partners across sectors and an enhanced application of research.

Engaging Men in Intimate Partner Relationship Programs: Service Provider and Stakeholder Perspectives

Men’s intimate partner relationship services have focused on correcting the behaviors of male perpetrators of intimate partner (IPV) and/or domestic violence (DV). There is a need to advance IPV and DV prevention efforts by better equipping men with relationship skills. This study explores service providers’ and stakeholders’ perspectives about the challenges and strategies for assisting men to build better intimate partner relationships. Interviews were conducted with participants ( n = 30) from Canada and Australia who worked in the men’s intimate partner relationships sector. Three themes were inductively derived: (a) crisis management (barriers to engagement), (b) owning deficits and leveraging strengths (engaging though accountability and action), and (c) me then we (self-work as requisite for relationship success). Using a gender relations lens, we examined the influence of masculinities on men’s intimate partner relationships and engagement with services. Participants described crisis management challenges for men accessing services including shame, threats to masculine identity, and mental health challenges. Owning deficits and leveraging strengths hinged on men’s accountability and action, rather than assigning blame for problematic behaviors in accessing services. Related to this, the me then we theme highlighted men’s strength-based approaches in focussing on self-work to develop tangible skills and awareness needed to build healthy relationships. Overall, the findings indicate men’s healthy relationships hinged on working with masculine identities to inform their perspectives and behaviors. Men’s intimate partner relationship work likely requires labor at multiple levels (e.g., individual, partners, and systems) to secure the strong potential for reframing masculine identities as asset-building for men’s relationships.

Prioritising Children and Young People with Disability in Research About Domestic and Family Violence: Methodological, Ethical and Pragmatic Reflections

PurposeThe perspectives of children and young people with disability who experience domestic and family violence are under-researched, impeding the development of approaches that meet their needs. Knowledge gaps stem from the layered discursive positioning of disability, childhood/youth, or domestic and family violence in addition to the methodological, ethical and pragmatic complexity of research needed to understand their priorities and be attuned to their lived experience. This article explores methodological, ethical and practical challenges to centring their voices in research about domestic and family violence.MethodA conceptual framework of feminist disability theory and intersectionality informed our co-designed research, across three phases: (1) quantitative large-scale data linkage and case file analysis; (2) qualitative research with children and young people, their families and service providers and (3) stakeholder engagement workshops.ResultsWe reflect on how our research was able to prioritise the contextual agency of children and young people with disability, ways it could not, and other constraints.ConclusionChildren and young people with disability experiencing domestic and family violence hold an expert and unique vantage point on what happens to them. Amplifying their priorities for directing policy and organisational change requires more of researchers in terms of methods, but also more flexibility in how projects are funded to enable creativity and innovation. We call for collective attention to frameworks for supported decision-making and child ethics to progress inclusive research which recognises the importance of participation for children and young people with disability.

Music festival drug checking: evaluation of an Australian pilot program

BackgroundThis paper explores the feasibility of delivering a music festival-based drug checking service in Australia, evaluating service design and stakeholder acceptability.MethodsQuestionnaire and interview data were collected from adult service users and key stakeholders. A mixed methods approach was used to analyse the data on implementation, impact and acceptability.ResultsThe trial service tested 170 substances with more than 230 patrons (including individuals who attended in groups). Adult service users had an average age of 21 years. Voluntary participation in the evaluation resulted in 158 participants completing the pre-service questionnaire, most of whom also completed the post-service (147 participants). Eleven in-depth qualitative interviews were conducted with patrons in the weeks following the drug checking. Concordance between what the patron expected the drug to be and drug checking results occurred in 88 per cent (n = 139) of the sample. Evaluation results show that the experience of testing and the accompanying harm reduction brief interventions positively impacted on patrons’ self-reported drug harm reduction knowledge, trust of health providers and stated drug use intentions. The service was received positively by service users.ConclusionThis is the first independent evaluation of a pilot drug checking service in Australia. Consideration of operational feasibility and self-reported behavioural change suggests that the program was successful, although communication about the interpretation of drug checking results could be improved. Future studies should develop strategies for follow-up and consider the applicability of behavioural change theory.

Assuring safe artificial intelligence in critical ambulance service response: study protocol.

Early recognition of out-of-hospital cardiac arrest (OHCA) by ambulance service call centre operators is important so that cardiopulmonary resuscitation can be delivered immediately, but around 25% of OHCAs are not picked up by call centre operators. An artificial intelligence (AI) system has been developed to support call centre operators in the detection of OHCA. The study aims to (1) explore ambulance service stakeholder perceptions on the safety of OHCA AI decision support in call centres, and (2) develop a clinical safety case for the OHCA AI decision-support system. The study will be undertaken within the Welsh Ambulance Service. The study is part research and part service evaluation. The research utilises a qualitative study design based on thematic analysis of interview data. The service evaluation consists of the development of a clinical safety case based on document analysis, analysis of the AI model and its development process and informal interviews with the technology developer. AI presents many opportunities for ambulance services, but safety assurance requirements need to be understood. The ASSIST project will continue to explore and build the body of knowledge in this area.

683 UNDERSTANDING HOW DISCHARGE SERVICES FOR OLDER PATIENTS CAN BRIDGE THE GAP BETWEEN HOSPITAL, COMMUNITY AND SOCIAL CARE

Abstract Introduction UK policy recommends that discharge support is provided by hospital, community and social care staff. However, there is a lack of understanding regarding how these multiagency hospital discharge services work in practice, how they can be sustained and what service stakeholder experiences of them are. This research aimed to understand how integrated discharge services work and the views and experiences of stakeholders. Method A qualitative case study of a supported integrated hospital discharge service (SIHDS) for older people was undertaken, which involved interviews with service staff (hospital, community and social care), patients and carers. Staff, patients and carers were interviewed on their experiences of SIHDS. Staff also took part in a process mapping exercise to understand how the service works. Interviews were analysed using thematic analysis. Ethical approval was obtained for this research. Results A variety of staff (n = 14) and patients aged over 60 years (n = 11) and their informal carers/family members (n = 4) were interviewed. Three main staff themes emerged from the findings: 1. Preparedness for discharge and impact of discharge service; 2. Integration and impact on patient pathway and 3. Organisational aspects. The three main patient/carer themes were: 1. Support for patients; 2. Patient Outcomes and 3. Information exchange. The findings demonstrated that: SIHDS was seen as important to allow patients to be discharged home in a timely and safe manner; that communication is important at all levels of a SIHDS and SIHDS need to continuously evolve to provide patient centred care. Conclusion The findings from this qualitative case study allow the complexities involved in SIHDS to be understood from the experiences and perspectives of multiagency staff, patients and carers. It shows SIHDS are complex, but useful to overcome gaps between services. However, to effectively sustain a patient centred service it is important to regularly review and develop SIHDS.

RSTNCOVID Burns: A multi-centre service evaluation and stakeholder survey of the impact of COVID-19 on burns care in England, Wales and Northern Ireland

As the UK entered the first wave of the COVID-19 pandemic, the National Health Service published consensus guidance to the UK burns services advising changes to the acute management of burns to allow the continuation of safe care while protecting limited hospital resources. We aimed to describe the demographics of burns service users, changes to clinical pathways and experiences of the burns team during the first wave of the COVID-19 pandemic.All burns services in the UK were invited to participate in a national collaborative, trainee-led study supported by the Reconstructive Surgery Trials Network. The study consisted of (1) a service evaluation of patients receiving burns treatment during the COVID-19 pandemic; (2) a multidisciplinary team survey. Analyses were descriptive and narrative depending on data types.Collaborators from 18 sites contributed data from burns MDT surveys and 512 patients. Patient demographics were consistent with typical burns patterns in the UK. The delayed presentation occurred in 20% of cases, with 24 patients developing complications. MDT surveys indicated substantial adaptations and challenges as a result of the pandemic. Access to theatres and critical care were limited, yet a comprehensive acute burns service was maintained. Telemedicine was utilised heavily to reduce patient footfall.Adaptations in the provision of burns care, including greater outpatient care and telemedicine, have emerged out of necessity with reported success. The impact of reduced scar therapy and psychological interventions for burns patients during the pandemic requires longer-term follow-up. Lessons from the UK experience can be used to strategise for future pandemics.