Now showing 1 - 10 of 13
  • Publication
    Clarifying the mechanisms and resources that enable the reciprocal involvement of seldom heard groups in health and social care research: A collaborative rapid realist review process
    Objective: Public and patient involvement is increasingly embedded as a core activity in research funding calls and best practice guidelines. However, there is recognition of the challenges that prevail to achieve genuine and equitable forms of engagement. Our objective was to identify the mechanisms and resources that enable the reciprocal involvement of seldom heard groups in health and social care research. Methods: A rapid realist review of the literature that included: (a) a systematic search of CINAHL, PsycINFO, PubMed and Open Grey (2007‐2017); (b) documents provided by expert panel members of relevant journals and grey literature. Six reference panels were undertaken with homeless, women's, transgender, disability and Traveller and Roma organizations to capture local insights. Data were extracted into a theory‐based grid linking context to behaviour change policy categories. Main results: From the review, 20 documents were identified and combined with the reference panel summaries. The expert panel reached consensus about 33 programme theories. These relate to environmental and social planning (7); service provision (6); guidelines (4); fiscal measures (6); communication and marketing (4); and regulation and legislation (6). Conclusions: While there is growing evidence of the merits of undertaking PPI, this rarely extends to the meaningful involvement of seldom heard groups. The 33 programme theories agreed by the expert panel point to a variety of mechanisms and resources that need to be considered. Many of the programme theories identified point to the need for a radical shift in current practice to enable the reciprocal involvement of seldom heard groups.
      567Scopus© Citations 34
  • Publication
    Contact tracing during the COVID-19 outbreak: a protocol for enabling rapid learning from experiences and exploring the psychological impact on contact tracers
    Background: Given the unprecedented nature of the COVID-19 pandemic, the Irish health system required the redeployment of public sector staff and the recruitment of dedicated contact tracing staff in the effort to contain the spread of the virus. Contact tracing is crucial for effective disease control and is normally a role carried out by public health teams. Contact tracing staff are provided with rapid intensive training but are operating in a dynamic environment where processes and advice are adapting continuously. Real-time data is essential to inform strategy, coordinate interconnected processes, and respond to needs. Given that many contact tracers have been newly recruited or redeployed, they may not have significant experience in healthcare and may experience difficulties in managing the anxieties and emotional distress of members of the public. Aim: This research aims to: (i) identify emerging needs and issues and feed this information back to the Health Service Executive for updates to the COVID-19 Contact Management Programme (CMP); (ii) understand the psychological impact on contact tracers and inform the development of appropriate supports. Methods: We will use a mixed-methods approach. A brief online survey will be administered at up to three time points during 2021 to measure emotional exhaustion, anxiety, general health, and stress of contact tracing staff, identify tracing systems or processes issues, as well as issues of concern and confusion among the public. Interviews will also be conducted with a subset of participants to achieve a more in-depth understanding of these experiences. Observations may be conducted in contact tracing centres to document processes, practices, and explore any local contextual issues. Impact: Regular briefs arising from this research with data, analysis, and recommendations will aim to support the work of the CMP to identify problems and implement solutions. We will deliver regular feedback on systems issues; challenges; and the psychological well-being of contact tracing staff.
    Scopus© Citations 3  466
  • Publication
    Evaluations of post-disaster recovery: A review of practice material
    (Australia and New Zealand School of Government, 2016-12) ; ;
    This paper reviews evaluations of post-disaster recovery efforts. The focus is on operational material and other ‘grey literature’ from disasters that have occurred in Australia, New Zealand and internationally. We develop a typology that categorises disaster events and includes whether evaluations were undertaken; the methods used; and whether the evaluations focused on the processes or outcomes of the recovery program. The review finds a lack of evaluation of post-disaster recovery. Where evaluations have been conducted, they are mostly process- rather than outcomes-based. There is a need for guidance for post-disaster recovery programs to support evaluation practice to determine the effectiveness, efficiency and appropriateness of post-disaster recovery interventions. There is significant investment in post-disaster recovery programs, with little known of their effectiveness. This review identifies useful case studies and methods to evaluate post-disaster recovery efforts, and informs the development of a national post-disaster evaluation framework.
      509
  • Publication
    ‘Bottoms up’: A case study on integrating public engagement within a university culture
    This study tracks the integration of public engagement within the systems, structures and culture of a university in Ireland. Public engagement, as an activity of research institutes, is gaining increased attention from policy and funding sources across Europe. However, little has been heard on the processes and practices which bring public engagement to the fore of conversations and activities in such institutions. In this practice case study, we track the evolution of a community of practice of public engagement in an Irish university over three years, through a bottom-up approach taken by a small group of faculty and staff, and organized through collective leadership to maintain momentum over the time period. With the support of key leadership figures, who provided top-down financial and structural support, we trace the narrative of defining public engagement within the university through stakeholder workshops, recording relevant activities with an institution-wide census, updating university public engagement reporting metrics, and establishing an active community of practice. Four key learnings are identified from this collective narrative: (1) the need for patience in attempting to instigate change within an institution; (2) the importance of establishing a shared understanding; (3) the importance of enacting collective leadership as a community; and (4) the necessity of leadership support with grass-roots activity. Reflection on these learnings suggests that the embedding of public engagement in institutions requires both personal and institutional investment.
      28
  • Publication
    Social Distancing and Direct Provision
    An open letter signed by over 900 experts, to the Irish Government and officials responsible for Ireland's Covid-19 response requesting, in light of clear public health necessities, to provide own-door accommodation and individualised access to sanitation and eating facilities to every family unit and single person in the international protection system in the system of direct provision. The response of the then Minister for Justice to this letter is also included. The response of Michael Martin, then leader of the opposition, is also included.
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  • Publication
    What are the mechanisms that enable the reciprocal involvement of seldom heard groups in health and social care research? A rapid realist review protocol
    Background: The University College Dublin (UCD) PPI Ignite Connect Network will fundamentally embed public and patient involvement (PPI) in health-related research, education and training, professional practice and administration in UCD’s institutional structures and procedures. A significant focus of the programme of work is on actively engaging and developing long-term reciprocal relationships with seldom heard groups, via our ten inaugural partners. Methods: This rapid realist review will explore what are the mechanisms that are important in actively engaging seldom heard groups in health and social care research. The review process will follow five iterative steps: (1) clarify scope, (2) search for evidence, (3) appraise primary studies and extract data, (4) synthesise evidence and draw conclusions, and (5) disseminate findings. The reviewers will consult with expert and reference panels to focus the review, provide local contextual insights and develop a programme theory consisting of context–mechanism–outcome configurations. The expert panel will oversee the review process and agree, via consensus, the final programme theory. Review findings will follow the adopted RAMESES guideline and will be disseminated via a report, presentations and peer-reviewed publication. Discussion: The review will update and consolidate evidence on the mechanisms that enable the reciprocal engagement and participation of ‘seldom heard’ groups in health and social care research. Via the expert and reference process, we will draw from a sizeable body of published and unpublished research and grey literature. The local contextual insights provided will aid the development of our programme theories. This new evidence will inform the design and development of the UCD PPI Ignite program focused on ensuring sustained reciprocal partnerships.
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  • Publication
    Defining and Supporting Public Engagement at University College Dublin: Summary Report
    Public engagement is recognised as a pathway to impact and currently there is an increased focus from policy and funding agencies on how universities engage with diverse audiences beyond the institution. There are already a wide range of creative and innovative public engagement activities underway across UCD. These include a spectrum of forms of engagement from informing and inspiring audiences through lectures or articles, to co-producing and co-designing research with members of the public (including patients and other stakeholders). A Public Engagement (PE) Working Group was recently established to further develop a culture of public engagement in UCD. The PE Working Group established that a definition of public engagement in UCD should be developed. This was done through a number of collaborative workshops with UCD staff (academic and administrative) and a workshop with members of the public held during the UCD Festival on the June 6th 2018. Without any information available on the public engagement activities that are underway across the university, the PE Working Group undertook a census of public engagement activity in UCD. A total of 322 submissions were received in the census. Based on the census and workshops, the PE Working Group outline key proposals to develop a more supported, cohesive and encultured approach to Public Engagement in our university.
      584
  • Publication
    Enabling public, patient and practitioner involvement in co-designing frailty pathways in the acute care setting
    Background: Although not an inevitable part of ageing, frailty is an increasingly common condition in older people. Frail older patients are particularly vulnerable to the adverse effects of hospitalisation, including deconditioning, immobility and loss of independence (Chong et al, J Am Med Dir Assoc 18:638.e7–638.e11, 2017). The ‘Systematic Approach to improving care for Frail older patients’ (SAFE) study co-designed, with public and patient representatives, quality improvement initiatives aimed at enhancing the delivery of care to frail older patients within an acute hospital setting. This paper describes quality improvement initiatives which resulted from a co-design process aiming to improve service delivery in the acute setting for frail older people. These improvement initiatives were aligned to five priority areas identified by patients and public representatives.Methods: The co-design work was supported by four pillars of effective and meaningful public and patient representative (PPR) involvement in health research (Bombard et al, Implement Sci 13:98, 2018; Black et al, J Health Serv Res Policy 23:158–67, 2018). These pillars were: research environment and receptive contexts; expectations and role clarity; support for participation and inclusive representation and; commitment to the value of co-learning involving institutional leadership.Results: Five priority areas were identified by the co-design team for targeted quality improvement initiatives: Collaboration along the integrated care continuum; continence care; improved mobility; access to food and hydration and improved patient information. These priority areas and the responding quality improvement initiatives are discussed in relation to patient-centred outcomes for enhanced care delivery for frail older people in an acute hospital setting.Conclusions: The co-design approach to quality improvement places patient-centred outcomes such as dignity, identity, respectful communication as well as independence as key drivers for implementation. Enhanced inter-personal communication was consistently emphasised by the co-design team and much of the quality improvement initiatives target more effective, respectful and clear communication between healthcare personnel and patients. Measurement and evaluation of these patient-centred outcomes, while challenging, should be prioritised in the implementation of quality improvement initiatives. Adequate resourcing and administrative commitment pose the greatest challenges to the sustainability of the interventions developed along the SAFE pathways. The inclusion of organisational leadership in the co-design and implementation teams is a critical factor in the success of interventions targeting service delivery and quality improvement.
      337Scopus© Citations 37
  • Publication
    “What Bothers Me Most Is the Disparity between the Choices that People Have or Don’t Have”: A Qualitative Study on the Health Systems Responsiveness to Implementing the Assisted Decision-Making (Capacity) Act in Ireland
    Objective: The Assisted Decision-Making (ADM) (Capacity) Act was enacted in 2015 inIreland and will be commenced in 2021. This paper is focused on this pre-implementation stage withinthe acute setting and uses a health systems responsiveness framework. Methods: We conductedface-to-face interviews using a critical incident technique. We interviewed older people includingthose with a diagnosis of dementia (n=8), family carers (n=5) and health and social care professionals(HSCPs) working in the acute setting (n=26). Results: The interviewees reflected upon a healthcaresystem that is currently under significant pressures. HSCPs are doing their best, but they are oftenhalted from delivering on the will and preference of their patients. Many older people and familycarers feel that they must be very assertive to have their preferences considered. All expressedconcern about the strain on the healthcare system. There are significant environmental barriers thatare hindering ADM practice. Conclusions: The commencement of ADM provides an opportunityto redefine the provision, practices, and priorities of healthcare in Ireland to enable improvedpatient-centred care. To facilitate implementation of ADM, it is therefore critical to identify andprovide adequate resources and work towards solutions to ensure a seamless commencement ofthe legislation.>
      299Scopus© Citations 12
  • Publication
    New Ways of Working? A Rapid Exploration of Emerging Evidence Regarding the Care of Older People during COVID19
    Health and social care staff have had to quickly adapt, respond and improve teamwork, as a response to the COVID-19 pandemic. Our objective was to rapidly summarize the emerging evidence of new ways of working in the care of older people during this period. We conducted an exploration of the emerging evidence within the timeframe of 1 March 2020 to 11 May 2020. To capture a broad perspective, we undertook thematic analysis of Twitter data which was extracted through a broad search for new ways of working in health and social care. For a more in-depth focus on the health and social care of older people, we undertook a systematic scoping of newspapers using the Nexis UK database. We undertook a validation workshop with members of the interprofessional working group of the Irish National Integrated Care Programme for Older People, and with researchers. A total of 317 tweets were extracted related to six new ways of working. There was evidence of using telehealth to provide ongoing care to patients; interprofessional work; team meetings using online platforms; trust and collaboration within teams; as well as teams feeling empowered to change at a local level. 34 newspaper articles were extracted related to new ways of working in the care of older people, originating in England (n = 17), Wales (n = 6), Scotland (n = 6), Ireland (n = 4) and Germany (n = 1). Four main themes were captured that focused on role expansion, innovations in communication, environmental restructuring and enablement. The results of this exploration of emerging evidence show that health and social care teams can transform very rapidly. Much of the change was based on goodwill as a response to the pandemic. Further analysis of empirical evidence of changing practices should include the perspectives of older people and should capture the resources needed to sustain innovations, as well as evaluate gaps in service provision.
      321Scopus© Citations 16