Journal of evaluation in clinical practice
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Developing a feasible and sensitive evaluation strategy for a new mental health service is a challenge that requires consideration of what a service is trying to achieve and what a 'good' outcome might look like. Perinatal mental illnesses are complex in their causes and treatment. Mother Baby Units provide specialist perinatal mental health care to parents experiencing mental illness in the perinatal period, with evaluations demonstrating clinical and social outcomes. There has however been remarkably little research on how MBUs achieve these outcomes. ⋯ Articulating the approach to evaluation provides a contribution to evaluation knowledge for others evaluating complex public health interventions. The relational nature of perinatal mental health experiences challenges individualistic approaches to care delivery, funding and evaluation. As part of service establishment, there is a need to consider what a 'good' outcome of care might be and to develop evaluation approaches that capture the relational components of recovery as well as the factors that support families to sustain change.
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Observational Study
The Effect of Lean Hospital Practices on Nurses' Direct Care Activities: Time and Motion Study.
This study investigates the effects of lean management practices on nurses' direct patient care activities and the interruptions they encounter in healthcare settings. The literature indicates that lean management enhances efficiency and improves patient care. Increased nursing time per patient correlates with better outcomes; however, rising patient loads and frequent interruptions hinder nurses' ability to deliver effective care, jeopardising patient safety. Addressing these inefficiencies is essential, given nurses' critical role in ensuring quality care. ⋯ Lean management effectively reduces waste and improves direct patient care time, enhancing patient safety and care quality. Continuous improvement initiatives in nursing practices are essential for success.
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What is known about how the level of social support, which is among the factors affecting medication adherence, affects medication adherence is limited. ⋯ Understanding the effect of perceived social support on immunosuppressive medication adherence is important for designing future interventions to increase immunosuppressive medication adherence.
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Randomized Controlled Trial Pragmatic Clinical Trial
Podiatric Clinical Triage in a Foot and Ankle Orthopaedic Clinic: A Randomised Trial.
Hospitals are increasingly utilising allied-health professionals to provide clinical triage to patients. While these positions are routinely implemented, and several observational studies have reported positive outcomes, the effectiveness of this intervention has been rarely tested in a clinical trial. ⋯ A clinical triage service has minimal impact on PROMS for foot and ankle pain or chronic musculoskeletal pain, but it is generally well-received, is cost-effective, and participants were more likely to report global improvement if they attended.