Partnership Working Research Articles

Perspectives on multi‐benefit water reuse systems: A confluence of water and wastewater management planning

AbstractThe multiple benefits of water reuse have yet to be fully realized in our urban water management systems. One pathway to optimal implementation is to plan for their integration with wider assets in water resource or drainage and wastewater management plans. This paper explores the perspectives of water resource and wastewater management planners. Qualitative data was gathered from a workshop organized by the Chartered Institution for Water and Environmental Management (CIWEM) with 25 participants from England's Water Service Providers (WSPs), regulators (Ofwat and the Environment Agency) and consultants working within the UK water sector. The participants acknowledged that water reuse is relevant to both water resource and drainage and wastewater management planning, but that current regulatory and funding frameworks are constraining effective engagement between water resource and drainage and wastewater management planners by encouraging the development of separate plans. A general consensus of the participants was that it would be beneficial to include water reuse technology within current and future Water Resource Management Plans (WRMPs) and Drainage and Wastewater Management Plans (DWMPs). Participants suggested this could be developed through collaborative working partnerships and support from regulatory and funding frameworks that allow for the growth and development of innovative technologies and nature‐based solutions. Participants also highlighted a stronger economic case could be made for water reuse technologies if the approach seeks to capture the wider benefits and not only the ‘best value’ solution. Societal acceptance and the availability of good quality data will be key to the successful adoption of any incentivized water reuse schemes.

Engaging early career researchers in a global health research capacity-strengthening programme: a qualitative study

BackgroundResearch capacity-strengthening is recognized as an important component of global health partnership working, and as such merits monitoring and evaluation. Early career researchers are often the recipients of research capacity-strengthening programmes, but there is limited literature regarding their experience.MethodsWe conducted a qualitative study as part of an internal evaluation of the capacity-strengthening programme of the international HERA (HEalthcare Responding to violence and Abuse) research group. Semi-structured interviews were conducted with group members, and thematic analysis was undertaken.ResultsEighteen group members participated; nine of these were early career researchers, and nine were other research team members, including mid-career and senior researchers. Key themes were identified which related to their engagement with and experience of a research capacity-strengthening programme. We explored formal/planned elements of our programme: mentoring and supervision; training and other opportunities; funding and resources. Participants also discussed informal/unplanned elements which acted as important facilitators and/or barriers to engaging with research capacity-strengthening: English language; open relationships and communication; connection and disconnection; and diversity. The sustainability of the programme was also discussed.ConclusionsOur study gives voice to the early career researcher experience of engaging with a research capacity-strengthening programme in a global health group. We highlight some important elements that have informed adaptations to our programme and may be relevant for consideration by other global health research capacity-strengthening programmes. Our findings contribute to the growing literature and important discussions around research capacity-strengthening and how this relates to the future directions of global health partnership working.

Public Libraries and Health Promotion Partnerships: Needs and Opportunities

Objective – Across North America, public libraries have increasingly served their communities by working with partners to connect patrons to essential healthcare services, including preventative. However, little is known about the extent of these partnerships, or the need for them, as seen from the perspective of public library workers. In this study, we set out to address the following research question: What needs and opportunities are associated with health promotion partnerships involving public libraries? Methods – Using snowball sampling techniques, in September 2021, 123 library workers from across the state of South Carolina in the United States (US) completed an online survey about their health partnerships and health-related continuing education needs; an additional 19 completed a portion of the survey. Results – Key findings included that library capacity is limited, but the desire to support health via partnerships is strong. There is a need for health partnerships to increase library capacity to support health. Public libraries already offer a range of health-related services. Finally, disparities exist across regions and between urban and rural communities. Conclusion – As an exploratory study based on a self-selecting sample of public library workers in a particular state of the US, this study has some limitations. Nonetheless, this article highlights implications for a variety of stakeholder groups, including library workers and administrators, funders, and policy makers, and researchers. For researchers, the primary implication is the need to better understand, both from the public library worker’s perspective and from the (actual or potential) health partner’s perspective, needs and opportunities associated with this form of partnership work.

Five changes needed to Scottish cancer policy to support necessary transformation of services

Whilst Scottish healthcare policy has not yet set a clear direction for service transformation needed in lieu of budgetary constraints, it is important that policy makers are cognisant of where policy can support healthcare professionals to overcome barriers to service development, and better meet demand. An analysis of Scottish cancer policy is presented, informed by learning gained from supporting development of cancer services as a practitioner, insights from undertaking health service research, and known barriers to service developments. This paper is structured as five recommendations to policy-makers: the need to develop a shared understanding of quality care between policy makers and healthcare professionals to guide service development in the same direction; revisiting of partnership working given developing health and social care landscape; empowerment of national and regional networks and working groups to develop and implement Gold Standard care in speciality services; sustainability in the development of cancer services; and development of guidance relating to how services should be using and developing patient capacities.

Potentials and challenges of using co-design in health services research in low- and middle-income countries

Co-design with people having poor access to health services and fragile health systems in low- and middle-income countries can be momentous in bringing service users and other stakeholders together to improve the delivery and utilisation of health services. There is ample of evidence from high-income countries regarding how co-design can translate available evidence into developing acceptable, feasible, and adaptable health solutions in different settings. However, there is limited literature on co-design in health research in the context of low- and middle-income countries. Therefore, it is crucial to understand how knowledge about collaborative working can be translated into policy and practice in the context of low- and middle-income countries. Thus, this paper discusses the concept of co-design, co-production, and co-creation in health and the potentiality and challenges of using co-design in health services research in low- and middle-income countries. Despite the challenges, the co-design research has considerable potential to encourage the meaningful engagement of service users and other stakeholders in developing, implementing, and evaluating real-world solutions in low- and middle-income countries. It is essential to balance power dynamics in a co-design process through mutual recognition and respect, participant diversity, and reciprocity and flexibility in sharing. The inclusive and collaborative approach to working is complex due to existing rigid hierarchical structures, socio-cultural beliefs, political interference and working practices. However, this could be minimised by developing transparent terms of reference that reflect the value and benefits of equal partnership in particular co-design work.

Intrathecal drug delivery for cancer pain at the end of life: a case study.

Two-thirds of patients with advanced cancer have pain and, of these, approximately 10-20% do not respond to conventional pain management approaches. This case study concerns a hospice patient who received intrathecal drug delivery for intractable cancer pain at the end of life. This involved working in partnership with a hospital-based interventional pain team. Despite side-effects and complications associated with intrathecal drug delivery and the requirement for inpatient nursing care, intrathecal drug delivery was the best option for the patient. The case identifies the importance of a patient-centred approach to decision-making, effective partnerships between hospice and acute hospital teams, and nurse education as key factors contributing to the provision of safe and effective intrathecal drug delivery.

Does Place Actually Matter? Searching For Place-based Pedagogy amongst Impact and Intentionality

The emergence of this special issue of Metropolitan Universities journal, “The Pedagogy of Place-Based Initiatives and Anchor Institutions,” stems from developing, teaching, and evaluating courses and pedagogical programs at urban/metropolitan institutions. This issue is rooted in scholarly practice and focuses on the intersection of place-based initiatives and pedagogy. It interrogates how place-based initiatives such as hyper-local community-based learning and anchor frameworks impact teaching and learning in the classroom. This framing article for this special issue captures the themes and broader questions that emerged from the articles while proposing a line of inquiry to engage the readers with the special issue focus. Our line of inquiry throughout this special issue is whether a distinct pedagogy emerges from place-based initiatives such as anchor institution approaches and hyper-local community-based learning. We begin by interrogating how place-based initiatives such as anchor institution approaches and highly intentional partnership work do not guarantee a change in classroom instruction and may fail to impact pedagogy long-term. We provide examples of service-learning within our local professional context and draw from themes that emerged from the scholarly articles in this issue. We also noted the intersection of place, institution, and systemic context. We offer a framework for a pedagogy of place with committed approaches to these place-based intersections as we have experienced them in our practice and emerging from the issue’s scholarly articles.

Galvanizing Local Anti-Trafficking Partnership Work Using Intelligence: Profiling the Problem and Building Resilience

Prior research has evidenced the importance of collaboration and multi-agency partnership work in responding to human trafficking in both the UK and US. Three previous key studies are synthesized in this paper. We situate multi-agency anti-trafficking collaborative work within conceptualizations of “resilience” and mechanisms by which to achieve it, and draw comparisons between the structure, organization, and activities of anti-trafficking partnerships in the UK and US. We present results, reflections, and discussion regarding the utility of local-problem diagnosis and multi-agency, using collaborative intelligence analysis as a mechanism to galvanize and organize local partnership action, resulting from action research conducted in one police force area. We posit the replication of this “problem profile” exercise as a mechanism for anti-trafficking collaborators to galvanize their aims and day-to-day efforts to make their communities resilient to human trafficking. We close by arguing for resilience as a framing for this mechanism and for local collaborative efforts.

Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach.

Proceedings from the Second Medical Summit on Firearm Injury Prevention, 2022: Creating a Sustainable Healthcare Coalition to Advance a Multidisciplinary Public Health Approach.

The Emergence of Concerned Partnerships in the Ethical Marketization of Place: A Narrative Lens

This study adopts a narrative lens to investigate how place shapes the emergence and work of cross-sector partnerships (CSPs). Based on a qualitative inquiry of the marketization of Lapland, Finland, as the home of Santa Claus, four matters of concern around the ethicality of marketizing Lapland are followed: revitalization, commerciality, distortion, and imbalance. The findings show how CSPs emerge in the marketization of place through the mechanisms of narrative contestations and misalignment of marketized place and place-identity, and their (re)alignment at the nexus of marketization. The contestations and misalignment generate matters of concern from place, which in turn mobilize CSPs via two interrelated narrative practices: (i) problematizing and (ii) reimagining the marketized place to realign it with place-identity. The paper contributes the construct of concerned partnerships to the literature of CSPs, a place-based form of CSPs which consist of both market and non-market actors, including the place and its social and material resources. They are formed through matters of concern that emerge through misalignments of marketized place and place-identity, to realign them and sustain a place at a nexus of marketization.

Cold War Social Science: Transnational Entanglements by Mark Solovey and Christian Dayé, eds.

<i>Cold War Social Science: Transnational Entanglements</i> by Mark Solovey and Christian Dayé, eds.

The Ambulatory Dedicated Education Unit (DEU): An important example of academic practice partnership in ambulatory care.

Academic Practice Partnerships (APPs) work synergistically to support mutual goals and educate the nursing workforce of the future. Enhanced recognition of the need for undergraduate nursing educational experiences in ambulatory care has increased the importance of Ambulatory APPs specifically. One mechanism for building Ambulatory APPs and shifting clinical education into multiple spheres of care is the Ambulatory Dedicated Education Unit (DEU). Partners at the University of Minnesota and Mayo Clinic in Rochester, Minnesota developed an Ambulatory DEU in early 2019. Barriers to educating nursing students in the ambulatory setting were effectively mitigated through the design of the DEU and mutual efforts to sustain the Ambulatory APP through flexibility and adaptation. The Ambulatory DEU clinical learning model is a strong example of an effective Ambulatory APP. The DEU was effective in overcoming eight common barriers to clinical learning in ambulatory settings and engaged 28 expert ambulatory registered nurses in the clinical teaching of between 25 and 32 senior Bachelor of Science in Nursing (BSN) students each year. Each student participating in the DEU experienced 90h of ambulatory clinical learning. The Ambulatory DEU is in its fourth year and remains an effective mechanism for engaging nursing students in the competencies and complex care of ambulatory nursing. Increasingly complex nursing care is being provided in ambulatory care settings. The DEU is an effective mechanism to prepare students in the ambulatory sphere of care and is a unique opportunity for ambulatory practice partners to learn and grow from participating in a partnered teaching environment.

Transforming nursing care for children with serious long-term conditions: A mixed methods exploration of the impact of Roald Dahl Specialist Nurses in the United Kingdom

PurposeA new model of paediatric nursing, funded initially by a charitable organisation working in partnership with UK healthcare providers, was implemented to support children living with serious long-term conditions. This study explored, from the perspective of multiple stakeholders, the impact of services provided by 21 ‘Roald Dahl Specialist Nurses’ (RDSN) within 14 NHS Trust hospitals. Design and methodsA Mixed Methods Exploratory design commenced with interviews with RDSNs (n = 21) and their managers (n = 15), alongside a medical clinician questionnaire (n = 17). Initial themes (constructivist grounded theory) were validated through four RDSN focus groups, and informed development of an online survey of parents (n = 159) and children (n = 32). Findings related to impact were integrated using a six-step triangulation protocol. ResultsZones of significant impact included: Improving quality and experience of care; Improved efficiencies and cost-effectiveness; Provision of holistic family-centred care; and Impactful leadership and innovation. The RDSNs forged networks across inter-agency boundaries to safeguard the child and enhance the family experience of care. RDSNs delivered improvements across a range of metrics, and were valued for their emotional support, care navigation and advocacy. ConclusionsChildren living with serious long-term conditions have complex needs. Regardless of the specialty, location, organisation or service focus, this new model of care crosses organisational and inter-agency boundaries to ensure that the healthcare delivered has maximum impact. It has a profoundly positive impact on families. Practice implicationsThis integrated and family-centred model of care is strongly recommended for children with complex needs crossing organisational divides.

Library based walking groups in Scotland: Exploring benefits, challenges and opportunities

Public libraries support a range of health and wellbeing activities, however little research has been done into the provision of library adult walking groups. This paper reports on a unique study exploring how widely adult walking groups are provided through Scottish public libraries, as well as library staff perceptions of the benefits, challenges and opportunities of these services. A rich qualitative research approach was used, involving Freedom of Information requests to the 32 Scottish local authority regions, an online questionnaire with 106 complete responses, and 8 follow-up interviews with Scottish public library staff, with and without walking group experience. Thematic analysis was used to identify key themes from collected data. Results show that adult walking groups are not widely provided through Scottish public libraries. However, respondents identified benefits for user groups, including but not limited to: improvements to participants’ health and social wellbeing; and increased engagement with library services. A range of opportunities for public libraries were highlighted, including staff interest, partnership working and a current focus on health and wellbeing. Challenges encompass resource restrictions, variations in partnership working and lack of effective networking. This original study provides valuable insights into the provision of public library walking groups in Scotland. It suggests that many factors can potentially influence the success of this library health and wellbeing service, with a range of different possible approaches. Results indicate that successful provision of a public library walking group may require close partnership working; adequate networking and information-sharing between public library staff; as well as sufficient resources; and staff interest. This exploratory study provides transferable insights and a basis for future research.

Developing architecture of system management in the English NHS: evidence from a qualitative study of three Integrated Care Systems

ObjectiveIntegrated Care Systems (ICSs) mark a change in the English National Health Service to more collaborative interorganisational working. We explored how effective the ICS form of collaboration is in achieving...

Integrating Community Health Workers into Hospital Systems Through a Social Work Partnership: A Report from the Field.

While studies support the effectiveness of community health worker (CHW) services, best approaches for CHW integration in health systems are not well understood. We describe early outcomes from a partnership between a safety-net hospital systems' social work department and CHWs to address adverse social determinants of health of high-risk patients.

Optimising the process of knowledge mobilisation in Communities of Practice: recommendations from a (multi-method) qualitative study

BackgroundCommunities of Practice (CoPs) offer a strategy for mobilising knowledge and integrating evidence-based interventions into musculoskeletal practice, yet little is known about their practical application in this context. This study aimed to (i) explore the process of knowledge mobilisation in the context of a CoP to implement evidence-based interventions in musculoskeletal care and (ii) co-develop recommendations to optimise the process of knowledge mobilisation in CoPs.MethodsA qualitative study comprising observation of a CoP and related planning meetings (n = 5), and interviews with CoP stakeholders (including clinicians, lay members, managers, commissioners, academics) (n = 15) was undertaken. Data were analysed using thematic analysis and interpreted considering the Integrated Promoting Action on Research Implementation in Health Services theory. Public contributors were collaboratively involved at key stages of the study.ResultsFour themes were identified: identifying and interpreting knowledge, practical implementation of a CoP, culture and relationship building, and responding to the external context. Resource and infrastructure enabled the set-up, delivery and running of the CoP. Support for lay members is recommended to ensure effective participation and equity of power. CoP aims and purpose can develop iteratively, and this may enhance the ability to respond to contextual changes. Several recommendations for the practical application of CoPs are suggested to create the best environment for knowledge exchange and creation, support an equitable platform for participation, and help members to navigate and make sense of the CoP in a flexible way.ConclusionThis study identified how a CoP with diverse membership can promote partnership working at the intersection between knowledge and practice. Several important considerations for preparing for and operationalising the approach in implementation have been identified. Evaluation of the costs, effectiveness and impact of CoPs is needed to better understand the value added by the approach. More broadly, research is needed to explore the practical application of online CoPs and the role of international CoPs in optimising the uptake of innovations and best practice.

'To me, it's ones and zeros, but in reality that one is death': A qualitative study exploring researchers' experience of involving and engaging seldom-heard communities in big data research.

Big data research requires public support. It has been argued that this can be achieved by public involvement and engagement to ensure that public views are at the centre of research projects. Researchers should aim to include diverse communities, including seldom-heard voices, to ensure that a range of voices are heard and that research is meaningful to them. We explored how researchers involve and engage seldom-heard communities around big data research. This is a qualitative study. Researchers who had experience of involving or engaging seldom-heard communities in big data research were recruited. They were based in England (n = 5), Scotland (n = 4), Belgium (n = 2) and Canada (n = 1). Twelve semistructured interviews were conducted on Zoom. All interviews were audio-recorded and transcribed, and we used reflexive thematic analysis to analyse participants' experiences. The analysis highlighted the complexity of involving and engaging seldom-heard communities around big data research. Four themes were developed to represent participants' experiences: (1) abstraction and complexity of big data, (2) one size does not fit all, (3) working in partnership and (4) empowering the public contribution. The study offers researchers a better understanding of how to involve and engage seldom-heard communities in a meaningful way around big data research. There is no one right approach, with involvement and engagement activities required to be project-specific and dependent on the public contributors, researchers' needs, resources and time available. Two public contributors are authors of the paper and they were involved in the study design, analysis and writing.

Involving patients and carers in patient safety in primary care: A qualitative study of a co-designed patient safety guide.

Involving patients is a key premise of national and international policies on patient safety, which requires understanding how patients or carers want to be involved and developing resources to support this. This paper examines patients' and carers' views of being involved in patient safety in primary care and their views of potentially using a co-designed patient safety guide for primary care (PSG-PC) to foster both involvement and their safety. A qualitative study using semistructured face-to-face interviews with 18 patients and/or carers in primary care. Interviews were transcribed and analysis was conducted using an inductive thematic approach. Overall participants expressed enthusiasm for the PSG-PC as a tool to support patients and carers to be involved in patient safety in primary care. However, for some participants being involved in patient safety was seen as taking on the role of General Practitioner and had the potential to add an additional workload for patients. Participants' willingness or ability to be involved in patient safety was influenced by a range of factors including an invisible, often underacknowledged role of everyday safety for patients' interactions with primary care; the levels of involvement that patients wanted in their care and safetyand the work of embedding the PSG-PC for patients into their routine interactions with primary care. Participants identified components of the PSG-PC that would be useful to them, in particular, if they had a responsibility for caring for a family member if they had more complex care or long-term conditions. Involving patients and carers in patient safety needs a tailored and personalized approach that enables patients and carers to use resources like the PSG-PC routinely and helps challenge assumptions about their willingness and ability to be involved in patient safety. Doing so would raise awareness of opportunities to be involved in safety in line with personal preference. Patient and public involvement were central to the research study. This included working in partnership to develop the PSG-PC with patients and carers and throughout our study including in the design of the study, recruiting participants, interpretation of findings.

1230 PALLIATIVE CARE MOVEMENT DISORDERS MULTIDISCIPLINARY MEETING

Abstract Introduction It is well recognised that patients with Parkinson’s disease (PD) have significant symptom burden in advanced stages of their disease. Integration of movement disorder and palliative care services has been limited by concerns about resource and sustainability. We present our experience of establishing a movement disorders palliative care multidisciplinary meeting. Method In 2019 we established a multidisciplinary virtual bimonthly meeting between movement disorders and palliative care specialists. Referrals were accepted from movement disorder specialists, community Parkinson’s practitioners and palliative care specialists. Referring clinicians all actively applied primary palliative care approaches within their existing services. Aims of the meeting were to facilitate holistic management of complex needs, support advance care planning (ACP) and consider referral to specialist palliative care services. Result 37 patients in total were discussed over a 2-year period (although the service was limited for a time due to COVID pressures). On average 3 new patients were discussed per meeting. Reasons for referral included motor and non-motor symptoms, support with ACP, medication advice, caregiver concerns and emotional distress. Meeting outcomes included medication adjustments, expediting reviews, hospice support, carer support, and referral to other services. Since the meetings started 23 (62%) patients have died. Of these, 30% died in hospital compared with the national average of 43.4%. The average between discussion at the meeting and death was 139 days. The meeting has generated education opportunities, triggered joint assessments and a professionals’ framework for the palliative management of patients with a movement disorder. Conclusions We present the experience of an MDT embedded within an early integrated palliative care service for movement disorders. The MDT has strengthened partnership working and findings suggest that alongside active primary palliative care, specialist palliative care for PD can be sustainable and resource efficient in a UK setting.