Navigating Workforce Challenges in Long-Term Care: A Co-Design Approach to Solutions

International Journal of Environmental Research and Public Health, Journal Year: 2025, Volume and Issue: 22(4), P. 520 - 520

Published: March 28, 2025

(1) Background: The enduring impact of COVID-19 on the long-term care (LTC) sector remains uncertain, necessitating targeted efforts to address current and emerging challenges. This study aims identify key stressors faced by healthcare workers (HCWs) in LTC co-develop innovative, actionable strategies that mitigate these stressors, foster resilience, promote workforce retention. (2) Methods: utilized a qualitative co-design methodology within mixed-methods, multi-phase framework conducted between July 2023 October 2024. article focuses Phase 1, which involved 11 semi-structured focus groups steering group discussions with 24 HCWs, including personal support (PSWs), nurses, administrators across Ontario explore workplace-related distress shared understanding challenges sector. Data were audio-recorded, transcribed verbatim, analyzed using thematic analysis derive themes insights. (3) Results: Key from sessions included need for (i) effective workload management tools, (ii) prioritization psychological safety mental health services, (iii) reducing regulatory bureaucratic burdens, (iv) strengthening practices, (v) fostering recognition positive image. Co-design HCWs leaders facilitated identification priority issues high-level solutions, addressing issues, implementing programs, enhancing work–life integration, improving training, promoting settings. (4) Conclusions: deepens our workplace factors contributing HCWs’ distress. Leveraging approach offers valuable insights into lived experiences leaders. findings provide guidance policymakers create effective, tailored interventions actively engage mitigating recurrent

Language: Английский

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A qualitative exploration of barriers to efficient and effective structured medication reviews in primary care: Findings from the DynAIRx study

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(8), P. e0299770 - e0299770

Published: Aug. 30, 2024

Structured medication reviews (SMRs), introduced in the United Kingdom (UK) 2020, aim to enhance shared decision-making optimisation, particularly for patients with multimorbidity and polypharmacy. Despite its potential, there is limited empirical evidence on implementation of SMRs, challenges faced process. This study part a larger DynAIRx (Artificial Intelligence dynamic prescribing optimisation care integration multimorbidity) project which aims introduce Artificial (AI) SMRs develop machine learning models visualisation tools multimorbidity. Here, we explore how are currently undertaken what barriers experienced by those involved them.

Language: Английский

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A rapid review of interventions to improve medicine self‐management for older people living at home

Health Expectations, Journal Year: 2023, Volume and Issue: 26(3), P. 945 - 988

Published: March 14, 2023

Abstract Background As people age, they are more likely to develop multiple long‐term conditions that require complicated medicine regimens. Safely self‐managing medicines at home is challenging and how older can be better supported do so has not been fully explored. Aim This study aimed identify interventions improve self‐management for living the aspects of address. Design A rapid review was undertaken publications up April 2022. Eight databases were searched. Inclusion criteria as follows: 65 years age or their informal carers, home. Interventions needed include least one component self‐management. Study protocols, conference papers, literature reviews articles in English language included. The results from reported through narrative synthesis, underpinned by Resilient Healthcare theory. Results Database searches returned 14,353 results. One hundred sixty‐seven individually appraised (full‐text screening) 33 included review. majority identified educational. In most cases, people's adherence increase knowledge medicines. Only very few addressed potential issues with supply. a minority specifically targeted either polypharmacy, multimorbidities frailty. Conclusion To date, emphasis supporting manage on ability adhere Most target deficiencies within patient, rather than preparing patients problems inherent management system. Medicine requires much wider range skills taking prescribed. anticipate respond may reduce risk harm associated polypharmacy contribute increased resilience Patient Public Contribution patient lived experience contributed towards shaping research question well inclusion exclusion this She also coauthor article. advisory group oversaw study.

Language: Английский

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Co‐designing an intervention to improve the process of deprescribing for older people living with frailty in the United Kingdom

Health Expectations, Journal Year: 2022, Volume and Issue: 26(1), P. 399 - 408

Published: Nov. 24, 2022

Abstract Background In older people living with frailty, polypharmacy can lead to preventable harm like adverse drug reactions and hospitalization. Deprescribing is a strategy reduce problematic polypharmacy. All stakeholders should be actively involved in developing person‐centred deprescribing process that involves shared decision‐making. Objective To co‐design an intervention, supported by logic model, increase the engagement of frailty deprescribing. Design Experience‐based approach service improvement, which uses users providers identify problems design solutions. This was used create intervention potential improve quality outcomes process. A ‘trigger film’ showing talking about their healthcare experiences created facilitated discussions current Problems were then prioritized appropriate solutions developed. The review located context processes procedures. An ideal care pathway complex deliver better Setting Participants Older informal carers professionals and/or working West Yorkshire, England, UK. considered primary care. Results differed from pathway. containing seven elements required move towards Three these prototyped four still need development. responded priorities (a) clarity for what happening at all stages (b) one‐to‐one consultations. Conclusions Priorities improving successfully identified. Solutions developed structured as intervention. Further work underway complete prototyping conduct feasibility testing. Patient or Public Contribution (and carers) have made central contribution, collaborators, ensure has greatest possible enhance experience medicines.

Language: Английский

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Barriers to person-centered service design in pharmacy practice: examples, lessons, and potential solutions

International Journal of Clinical Pharmacy, Journal Year: 2024, Volume and Issue: 46(2), P. 542 - 547

Published: Jan. 9, 2024

Language: Английский

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A qualitative exploration of barriers to efficient and effective Structured Medication Reviews in Primary Care: Findings from the DynAIRx study

medRxiv (Cold Spring Harbor Laboratory), Journal Year: 2024, Volume and Issue: unknown

Published: April 19, 2024

Abstract Introduction Structured medication reviews (SMRs), introduced in the United Kingdom (UK) 2020, aim to enhance shared decision-making optimisation, particularly for patients with multimorbidity and polypharmacy. Despite its potential, there is limited empirical evidence on implementation of SMRs, challenges faced process. This study part a larger DynAIRx (Artificial Intelligence dynamic prescribing optimisation care integration multimorbidity) project which aims introduce Artificial (AI) SMRs develop machine learning models visualisation tools multimorbidity. Here, we explore how are currently undertaken what barriers experienced by those involved them. Methods Qualitative focus groups semi-structured interviews took place between 2022-2023. Nine were conducted doctors, pharmacists clinical pharmacologists (n=21), three patient at high-risk rapidly worsening health from (n=13). Five held 2 pharmacists, 1 trainee doctor, policy-maker psychiatrist. Transcripts analysed using thematic approach. Results Two key themes limiting effectiveness practice identified: ‘Medication Reviews Practice’ ‘Medication-related Challenges’. Participants noted limitations efficient including scarcity digital identifying prioritising SMRs; organisational patient-related inviting ensuring they attend; time-intensive nature need multiple appointments decision-making; impact healthcare context SMR delivery; poor communication data sharing issues primary secondary care; difficulties managing mental medications specific associated anticholinergic medication. Conclusion complex, time consuming may require follow-up enable comprehensive review. There support system identify, prioritise reduce needed understand journey when dealing large volumes disparate information electronic records. However, monitoring effects changes feedback loop can be challenging establish maintain current record systems.

Language: Английский

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Consumer Involvement in the Design and Development of Medication Safety Interventions or Services in Primary Care: A Scoping Review

Health Expectations, Journal Year: 2024, Volume and Issue: 27(6)

Published: Nov. 17, 2024

Medication-related problems remain a significant burden despite the availability of various interventions and services in primary care. Involving health care consumers to design or across disciplines is becoming more widely used as this type engagement reportedly leads accessible, acceptable sustainable quality life. We conducted scoping review examine when how have been involved development medication safety within

Language: Английский

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Enhancing care in the initiation and management of insulin in older people with diabetes: A collaborative journey with older individuals and their caregivers using Experience-Based Co-Design

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(7), P. e0302516 - e0302516

Published: July 29, 2024

Introduction Initiating insulin therapy in older individuals with type 2 diabetes (T2DM) poses unique challenges and requires a nuanced understanding of the age-related factors that impact safety efficacy. This study employed Experience-Based Co-Design (EBCD) to enhance initiation management experience for this population, emphasising collaborative approach involving patients, caregivers, healthcare professionals. Aim The primary aim research was develop tailored care pathway, utilising co-design Behaviour Change Wheel (BCW), which addressed issues specific adults on therapy. sought identify key challenges, propose practical interventions, construct logic model illustrating pathway enhanced treatment experiences. Methods An adapted EBCD process used integrated Medical Research Council (MRC) Framework BCW. involved thematic synthesis, video interviews, feedback focus groups ’Crazy Eights’ brainstorming method, as part workshop, generated solutions informed subsequent development. Results Focus group findings revealed distressing experiences, inconsistent dietary advice, perceived disparities between 1 diabetes. workshop identified eight leading proposed interventions aligned illustrates undergoing treatment, behaviour change among Conclusion efforts participants contributed valuable insights terms educational emotional needs importance continuity improving access specialist services. Findings from can be inform support strategies T2DM during their transition ongoing management.

Language: Английский

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A Qualitative Meta-Synthesis of the Challenges Perceived by Nurses in Home Health Nursing

Journal of Community Health Nursing, Journal Year: 2023, Volume and Issue: 40(3), P. 182 - 193

Published: March 31, 2023

Purpose To aggregate and synthesize the findings of qualitative studies exploring challenges perceived by nurses in home health nursing.Design A meta-synthesis.Method comprehensive search multiple databases was conducted December 2020 updated October 2022. Data were analyzed using meta-aggregation method, analytical process used to derive themes inductive.Findings Eleven included, four major identified: (1) performance duties, (2) struggles with specific restricted factors related practice, (3) underestimation value emotion, (4) a difficult-to-surmount relationship gap.Conclusions Clinical Evidence Home nursing is associated numerous due its complexity high demand. The this study are beneficial respect obtaining deeper understanding nursing. After considering existing problems, it necessary take measures overcome these challenges, individuals, families society should make efforts develop profession further.

Language: Английский

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