Call for Papers: Special issue on Community Informatics for Health - Journal of Community Informatics

Abstract submissions due 14 March 2011

A special issue of the international Journal of Community Informatics (http://ci-journal.net) is going to be devoted to Health. Community Informatics (CI) is the study and the practice of enabling communities with Information and Communications Technologies (ICTs). This special issue will focus on how the social application of ICTs can empower and enable communities towards improving health. The issue is expected to be published in late 2011. The Journal of Community Informatics is a focal point for the communication of research of interest to a global network of academics, community informatics practitioners and national and multi-lateral policy makers.

The field of community informatics seeks to explore the potential of information and communication technologies and their applications for social and economic development efforts at the community level. It particularly seeks to ensure that marginalized individuals and communities can benefit from the opportunities that ICTs can provide. In the area of health, this is all the more important since those with poorer health status and poorer health outcomes are usually those with less (or no) access to ICTs, or are those who have fewer skills to make use of and benefit from ICTs.

For this special issue of the Journal on Health, we are inviting submission of original, unpublished articles. We welcome research articles, along with case studies and notes from the field. All research articles will be double blind peer-reviewed. Insights and analytical perspectives from practitioners and policy makers in the form of notes from the field or case studies are also encouraged - these will not be peer-reviewed.

Please read the full Call for Papers and more specific information on the intended 'flavour' of the issue at: http://www.flinders.edu.au/medicine/sites/southgate/research/projects/digital-tech-health/

Guest editors:

*  Lareen Newman PhD, Southgate Institute for Health Society & Equity, Flinders University - Australia
*  Ali Al Sanousi MD, King Faisal Specialist Hospital & Research Centre, Riyadh - Saudi Arabia

Contact for queries and abstract submissions:  lareen.newman AT flinders.edu.au

IMPORTANT DATES
Deadline for abstracts: 14 March 2011
Notification of successful abstracts:  9 May 2011
Deadline for submission of full papers/articles: 31 August 2011
Estimated publication date: November 2011

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Dr Lareen Newman, DipEurLangs (Hons), BA (Hons), PhD
Senior Research Fellow
Southgate Institute for Health Society & Equity
Flinders University - Adelaide, South Australia
Personal page: http://www.flinders.edu.au/people/lareen.newman
Program page: http://flinders.edu.au/medicine/sites/southgate/
CRICOS Provider Number: 00114A

Additional link: h2cm in community informatics ....
Jones, P. (2004) The Four Care Domains: Situations Worthy of Research. Conference: Building & Bridging Community Networks: Knowledge, Innovation & Diversity through Communication, Brighton, UK.

compose, direct, conduct and 'dilute to taste' outcomes

In Drupal musings 12 I mentioned that the classification of nursing practice is not necessarily at the forefront of nursing's mind set against the turbulence and rush of clinical areas.* This is especially so at the moment as nurses on wards, clinics and community try to identify savings.

I am interested in classification in part as this is the raison d'être for the health career model; on a mental (cognitive) level, in practice and potentially in virtual representations of health care activities. For learners it is an extra to hold the bicycle saddle for those first turns of the pedals. Additionally, for those who have completed many rides and races (lifelong learners) they can reflect on how they got there, and plan for the next round.

As a conceptual framework then h2cm is, like classification, in the background. The model can help to compose, direct and conduct (c-d-c) nursing (health and social) care. Classification matters to ALL nurses because we need to know not only the c-d-c of nursing but the outcomes too.

If all the above is in the background, then together with classification the health career model can help differentiate nursing as a discipline and make nursing visible. We can only take heed of the adage "divide and conquer" by being able to differentiate nursing from other disciplinary contributions. Then perhaps we can truly identify and so define the facets of integrated, interprofessional and multidisciplinary care that must also be person-centred. As nurses and the team respond to the individual's trauma (assault, illness, chronic disease ...), they can also assure their combined values, which must be defined and articulated if there is to be a unified philosophy.

If the respective professions have not noticed (I am sure they have) 'professionalism' is itself under assault in terms of unique knowledge and skills, respect, power and status. To a degree this a good thing. It is also called 'progress': countering restrictive practices, improving service access and challenging institutionalised and state paternalism. Professionalism is accorded for reasons of accountability, education, responsibility, integrity and advocacy. Amid the public (mental) health disaster that we face - the professions - are needed more than ever and if the assault is taken too far ... ?

* Should you know of examples where classification IS at the forefront of nursing practice please let me know - h2cmng @ yahoo.co.uk.

Book: "Outcome Measurement in Mental Health" Cambridge University Press

Outcome Measurement in Mental Health
Theory and Practice
Edited by Tom Trauer
Hardback
Published June 2010

In order to operate in an evidence-based fashion, mental health services rely on accurate, relevant, and systematic information. One important type of information is the nature of the problems experienced by recipients of mental health care, and how these problems change over the course of time. Outcome measurement involves the systematic, repeated assessment of aspects of health and illness, either by service providers, service recipients, or both. From outcome measurement clinicians and service recipients achieve a common language whereby they can plan treatment and track progress, team leaders and managers secure a basis to compare their services with others and to promote quality, while policy makers and funders derive evidence of effectiveness. This book will be an essential and practical resource for all members of the mental health clinical team as well as those responsible for establishing or managing services, and directing policy.

• Presents a global perspective on outcome measurement enabling readers to compare and contrast practices around the world
• Enables readers to identify the specific challenges presented in different groups and settings, the instruments to use, and how to use the results
• Emphasizes the relevance and use of outcome data to clinicians, to help them improve their effectiveness

Contents

Preface; 1. Introduction Tom Trauer; Part I. Outcome Measurement Around the World: 2. Mental health outcome measurement in Australia Jane Pirkis and Tom Callaly; 3. Outcome measures in New Zealand Graham Mellsop and Mark Smith; 4. Outcome measurement in England Mike Slade; 5. Outcome measurement in Ohio and the United States James Healy and Dee Roth; 6. The outcome questionnaire system: a practical application for mental health care settings Michael J. Lambert; 7. Outcome measurement in Italy Mirella Ruggeri; 8. Outcome measurement in Germany Sylke Andreas, Thomas Becker, Holger Schulz and Bernd Puschner; 9. Outcome measurement in mental health services in Norway Torleif Ruud; 10. Outcome measurement in Canada: one province's experience with implementation in community mental health David Smith; Part II. Outcome Measurement in Specific Groups and Settings: 11. Routine outcome measurement in child and adolescent mental health Peter Brann; 12. Outcome measurement in adult mental health services Tom Trauer; 13. Outcome measurement in older persons Rod McKay and Regina McDonald; 14. Outcome measurement with indigenous consumers Tricia Nagel and Tom Trauer; 15. Routine measurement of outcomes by Australian private hospital-based psychiatric services Allen Morris-Yates and Andrew Page; 16. Mental health outcome measurement in Non-Governmental Organizations (NGOs) Glen Tobias; 17. Outcome measurement in drug and alcohol services Maree Teesson and Mark Deady; Part III. Current Issues in Outcome Measurement: 18. Outcome measurement - applications and utility Tom Trauer; 19. Stakeholder perspectives in outcome measurement Tom Trauer; 20. Assessment of change in outcome measurement Tom Trauer; 21. Routine outcome measurement: perspectives on skills and training Tom Trauer and Tim Coombs; 22. A review of instruments in outcome measurement Tom Trauer; 23. Some economic and policy considerations for outcome measurement Rowena Jacobs; 24. Future directions Tom Trauer; Index.

http://www.cambridge.org/uk/catalogue/catalogue.asp?isbn=9780521118347

My source:
UK Routine Clinical Outcomes Network Forum

HoNOS, checklists and semi-structured interviews

Mental health services not routinely (and formally) using HoNOS (Health of the Nation Outcome Scales) are gearing up with a push to implement the scale across services by April. HoNOS has been around for a long time almost 20 years so it is time it earned its keep. Perhaps high quality tools take time to emerge from the noise and chatter of the care marketplace? ;-)

Although they are available, I've been putting a presentation together to help get to grips with HoNOS in the role of a trainer. The evidence for the validity and benefits of using HoNOS is well established, with the HoNOS family of scales boasting global usage and development:

• HoNOS for working age adults
• HoNOS65+ for older people
• HoNOSCA for children and adolescents
• HoNOS-Secure for use in health and social care settings secure psychiatric, prison health care and related forensic services, including those based in the community)
• HoNOS-LD for learning disabilities
• HoNOS-ABI for acquired brain injury (ref.)
  

The number of assessment, intervention and evaluation tools available to clinicians AND managers begs the question (ironically): is there 'space' in the toolkit for yet another tool? If HoNOS can help establish a coherent currency for mental health commissioning beyond the block contract then this is most welcome. Mental health services need to move forward on several fronts. There is a timeline running with completion of this difficult task in its sights.

One set of guidance for HoNOS points out that:

The scales are not used as a checklist or semi-structured interview, but form a brief record of severity.

There is some succor there then, since Hodges' model is a checklist and a quad-structured interview there is still a role for a global conceptual framework.

There's nothing like a full and tidy set of tools!

Ref. http://www.gpsa.org.au/media/docs/mentalhealth/honos_information.pdf

DoH: Honos health of the nation outcome scales report on research and development July 1993 - December 1995

Additional links:

The UK Routine Clinical Outcomes in Mental Health Group

The NHS Information Centre: Mental Health Minimum Dataset

RCP references

BBC R4 Friday 8th Jan: NHS Punters Speak Out

This programme (episode 1) is on BBC Radio 4 on Friday 11.00:

With the help of dissatisfied NHS patients, Liz Barclay asks if the growing popularity of online feedback can really make a difference to standards of health care and treatment.

The culture of customers offering brickbats and bouquets to service providers has now extended beyond hotels and coffee chains to the NHS. Hospital rating websites invite patients to grade their hospital stay out of five stars, and to leave comments about the care they received.

Liz invites NHS patients who have used one of these patient rating websites to discuss their experiences and puts their points to the hospitals where they were treated.

She asks if the idea of online feedback can be really be applied to our health service and if it can genuinely improve standards of care. Critics suggest the sites are merely window-dressing and that NHS patients are not 'consumers'. Some health professionals claim that the sites can easily just become places where personal scores are settled against NHS staff.

<->

Introductions to Hodges' model for different audiences -

"Patiency" (person-centred care)	Health, Social Care professionals (inc. all in a student capacity)
The Public, Citizens	Managers, Policy Makers

These introductions will be re-written for the new website and represent possible projects for volunteers / students...?

Nursing human rights - dementia care II: fao Sir Gerry Robinson*

The 2nd and final edition of BBC Two's TV programs Can Gerry Robinson Fix Dementia Care Homes? was on last night and made for uneasy viewing.

The saving grace for the public's confidence (if there is one) was repetition of the excellent care at one home.

For all the negatives presented on TV, before mapping the key content of this program using Hodges' model it must be acknowledged that the staff and both managers involved are to be congratulated in allowing and facilitating the production of this program. Sir Gerry and the program's producer(s) obviously travelled an especially difficult course in this episode.

Unless qualified or having undergone some training, many staff will behave and eventually modify their norms and expectations according to what they are exposed to within a short period of starting to work in residential care. Perhaps, this explains in part the adage 'start as you mean to go on'? It was apparent that many staff knew they were failing, they recognised the lack of leadership, their inability to sustain the effort for positive change.

This is why (in 1977 at least) the school of nursing I attended was a little more than churlish about students initially working as a nursing assistant. If you were not working on a ward that also trained student nurses then you may adopt the wrong attitudes and with it what we might call 'non-skills'. This includes 'learning' means of avoiding contact and interaction with patients; and possibly interpreting behaviour in a purely negative and non-therapeutic way. This may extend to the point of becoming personally involved - taking things personally - whether the behaviour exhibited is aggression or sexual disinhibition, for example.

Here then are some of the points I noted, many are repeated from the first program with some very unfortunate and troubling additions (which I may further review as per the above text):

PURPOSE, CARE PHILOSOPHY (none?), person-centered care, attitude, memory loss, vulnerable individuals, training, risk, assessment, motivation to change, interpersonal skills, motivation, listening, life skills, knowledge and skills, feedback, aggression, agitation, measures, rapport, empathy, +ve care, boredom, personal choice & autonomy, access to personal belongings, dolls, personal focus, anxiety, psychological stress and trauma of physical relocation

physical environment, colour, decor, noise, outside access - physical security, physical restraint - use of furniture, position of furniture, day-to-day items, tasks, PROCESS, measures 'dementia care mapping', routine tasks, time with residents, assessment, care files (paper!), bed occupancy, activities - painting, gardening, sheds, staffing cover : resident ratios, models of care (none?), objective measures

PRACTICE (common minimum standards), the residents, team work, day staff:night staff, collective faith and trust, collaborative objectives, care, shared enthusiasm, social attitudes, dignity and respect, relationships, social values, personal-social history, engaged activities, involvement, 'social' norms, inclusion, community - institution, being valued by others, impact on families and local community of home closure

POLICY (the lines in the sand?), management spot checks, '24 hour care', disciplinary procedures, professionalism in management relationships, duty of care, ratings: tokenistic inspection regime, home closure, consultancy, audit, legislation, sickness, pay, business ethos, staff morale, recruitment and retention, confidentiality, sanctions, management style, qualifications, standards, institutionalised care, re-location, lessons learned (business involved, local authority)?

Once again, if you missed it there is an opportunity to watch the program on BBC iPlayer. There are also Open University learning resources associated with the program.

My closing thought: in closing the asylums over the past 40+ years I hope we have not and are not creating a series of micro-institutionalised replacements.

This is an issue for everyone.

*Please pardon the deliberate name-dropping (and not for the 1st time!).

Additional links:

The Care Quality Commission

POLITICAL care domain resources

SOCIOLOGICAL care domain resources

Open for applications: USA based Quality Improvement Fellowships

Dear NHS W2tQ readers,

Do you know of a clinically qualified NHS leader with a proven track record in quality improvement?
Do they have the potential to drive change and promote quality at a high level?

The Health Foundation's Quality Improvement Fellowships are now open for applications. Fellows will have an opportunity to spend a year in the USA working with the Institute for Healthcare Improvement (IHI) based in Cambridge, Massachusetts, studying the best international practice in quality improvement.

The fellowship includes:

• participation in the clinical effectiveness programme at the Harvard School of Public Health
• a personalised programme of taught and interactive learning at IHI
• active participation in the leadership teams for key IHI initiatives
• significant involvement in authorship and publication of research and improvement work
• strategic planning sessions to enable effective integration of a fellow's learning to better meet the needs of their home organisation

The Health Foundation will provide fellows with an allowance to support relocation, travel, visa and and USA healthcare costs, as well as replacement staff costs for their employing organisations.

Who can apply?
We are looking for senior NHS leaders who are clinically qualified and have a strong track record of achievement in the field of quality improvement.

Applicants must have the enthusiasm and potential to promote quality improvement nationally and to build organisational capability to drive quality improvement to higher levels of performance.

Please pass this information on to individuals who may be interested in applying.
The deadline for applications is 16 October 2009.

Visit Quality Improvement Fellowships or email awards@health. org.uk to find out more.

My source: Mental Health Informatics - SIG RCPsych via Stephen Thornton, The Health Foundation.

Nursing as reverse engineering...

At Scotland on Rails last month one of the sessions included an example of Ruby code outlining a 'morning routine'. It comprised a series of tasks and sub-tasks all of which led to getting to work.

Much of the vital essentials of the code I cannot understand beyond some tentative inklings, but in the hope of learning I've re-hashed the accessible bits and turned it into a NursingRoutine. The output looks like this....

Nursing....
"Non-judgmental attitude"
"Universal positive regard"
"Basic counselling skills"
"Open mind"
"Meet person"
"Receive referral"
"assess person utilizing Hodges model"
"Create care plan"
"Meet physical needs"
"Meet interpersonal needs"
"Meet political care needs"
"Meet social care needs"
"Holistic care"
"Evaluate physical needs"
"Evaluate interpersonal needs"
"Evaluate social care needs"
"Evaluate political care needs"
"Evaluate care"
"caring..."

Something like nursing is obviously a much more complex routine than that implied above - that is because:

• nursing is not [some - 'thing'];
• nursing can be represented as a routine BUT;
• nursing seeks to transcend the routine: emphasizing the personal, unique, the humanistic;
• nursing is parallel and sequential;

In addition now we are about collaborative, multidisciplinary care that must factor in agreement (the care plan...), and patient reported outcome measures (PROMS). ...

In the meantime I need to exercise care trying to understand the program that produced the output (that could also be easily printed as a list). While this is not an example there is such a thing as obfuscated code, but surely not obfuscated nursing care?

Defining e-Health

E-Health is a compound and dynamic term for people, health (and social) care education and delivery, organisations, information and communications technologies (ICT), infrastructures, policies and means combined to facilitate, measure and improve the intentions, actions and outcomes of health (and social) care.

In a nursing context people refers to patients, carers, nurses and public; means refers to partnerships plus funding ranging from the macro level of the public sector to personal budgets; intentions, actions and outcomes covers education, the nursing process, records, quantitative and qualitative metrics.

To be holistic metrics must incorporate safety, access, personal outcomes, benefits, integrated informatics and economics.

1st draft: (c) Peter Jones

Patient or Customer?: Caring under a panoply of words

Through twitter I came across a blog post 'Should patients be treated as customers' at Kevin MD.

I posted a comment and this post develops the thoughts there....

There is a panoply of words we apply in the various contexts covered by health and social care. Those associated with patient are subject to ongoing debate...

I use the word 'panoply' on purpose because individuals and services can hide behind words - or jargon - as we all do, using words as a defensive shield.

Panoply struck me with its multiple meanings. As definitions reveal the word suggests an abundance of something - 'flags'! Panoply also suggests something covered. A need to protect as per the meaning applied to armour.

A friend - a retired nurse - recently had an in-patient experience that proved rather shocking in terms of the past 3-4 decades of nursing theory and practice. During this time of course the nursing literature has espoused the need for individualised nursing care. All that effort according to my friend's particular patient experience or customer journey suggest that nursing has not moved on.

Perhaps there is a perpetual policy irony (PPI?!) that sets wiser heads rocking to-and-fro: the more something is in vogue - written and talked (flagged) about - the less it really applies in reality?

Which brings me back to KevinMD's post. There is and needs to be a tension between patients as passive players in the sense of them being (allowed to be) patients; and patients as members of the public with experience to translate into service improvement and change. Patients are also citizens - taxpayers and many of whom have a desire to push up the quality and accessibility of health and social care services.

The first stumbling steps of PROMS (patient reported outcome measures) is now under way to gauge quality and outcomes.

'Patients' will tend to be viewed as 'customers' when the systems used to collect their 'satisfaction ratings' of the 'patient experience' are adapted from existing CRM applications: re-engineered - tinkered and tailored - to suit another industrial commercial niche or market sector.

This is not to be cynical, it is being realistic about the commercial realities in which health and social care is practised.

There's a dated concept in nursing theory (and medicine) patiency. When does patiency begin? When does it end? Perhaps it is time to revisit this from an informational perspective?

If the public is engaged as per the Patient Public Initiative then (idealistically) they can 'shop around' before they extend their health career reach to the mobile paramedics (strategically sited around the community) and possibly on through to A&E. Then the public has acted politically and socially prior to their need to engage in the actual care processes themselves.

<>

Here's the post on the 'public' and the sanctity of records which includes some additional links...

(Confidential) Letter to self - and you, and you, and you... ?

http://hodges-model.blogspot.com/2009/02/confidential-letter-to-self-and-you-and.html

http://snipurl.com/beqf7 [hodges-model_blogspot_com]