Healthcare Quality Improvement Partnership

Abstract Due to a demonstrated relationship between Adverse Childhood Experiences (ACEs) and a range of psychological, physical, and social risks, there has been a growing movement to integrate routine ACEs screening in pediatric settings. As screenings have increased, there has also been a call for research to uncover areas for improvement in the implementation of these screenings. The Pediatric ACEs and Related Life Events Screener (PEARLS) is one common tool used for screening that has demonstrated construct validity in identifying three domains of adversity: maltreatment, household challenges, and social context. A second version of PEARLS (PEARLS v2) was adapted and refined in response to feedback collected from public health professionals, physicians, clinical psychologists, mental health specialists, and patients in a variety of settings, including clinics, state advisory boards, and health equity counsels. To ensure acceptability, this study examines caregiver feedback on PEARLS v2 through semi-structured interviews with 13 caregivers of child patients in Federally Qualified Health Centers. Using Rapid Qualitative Analysis, results highlight caregiver feedback on the addition of a written introduction to the screener and overall implementation preferences (i.e., location, length of time). Results also underscore caregiver feedback and suggestions on item clarity and acceptability, the addition of strength-based questions, perspectives on caregiver honesty in completing the screener, and preferences regarding provider response and resources. Findings support PEARLS v2 adaptations and provide caregiver-driven feedback to address acceptability and implementation of the screener in pediatric settings.

IntroductionTransparency in the use of data for research benefits the public and researchers by fostering trust and enabling efficient data sharing. Public support for access to their data for research depends on robust data security, the absence of conflicting interests, and a clear demonstration of public benefit, all of which must be evident through transparent practices. A lack of clarity in data access processes can delay research, highlighting the need for clear and streamlined approval procedures. To maintain what is often referred to as a ‘social license to operate’, organisations must meet and uphold societal expectations, with transparency being a key dimension of that responsibility.ObjectiveTo develop and foster adoption of a set of transparency standards for the data science community, supporting trustworthy and streamlined data use for health and socio-economic research and planning.MethodsA multi-stakeholder deliberation was undertaken, informed by two reviews of existing data access procedures across participating organisations. Stakeholders included healthcare and research organisations, data custodians, regulators, industry representatives, academic experts, and members of the public.ResultsThe review and deliberation identified missed opportunities to inform and involve the public in data access procedures, along with inconsistencies in data access processes and supporting materials across the organisations. In response, we developed the Transparency Standards, comprising 28 recommended actions grouped into four themes: provision of clear data access guidance; clear website navigation designed to meet the needs of public and research users; regular review and iterative improvement of processes; and reporting of data access outcomes and information security findings. A targeted funding call facilitated the adoption of standards in 19 organisations, resulting in reusable transparency materials and transferable knowledge to support wider implementation.ConclusionThe Transparency Standards support data custodians in strengthening openness and accountability in data access processes, helping to build public trust while simplifying procedures for researchers. Their broad adoption demonstrates a shared commitment to the ethical use of data. However, varying levels of implementation point to the need for continued investment to sustain progress and respond to public and researcher expectations.

During the COVID-19 pandemic, care homes for older adults in England implemented isolation, social distancing and other restriction measures to help protect residents from contracting the virus. Little was known about the physical and psychological impacts that these measures would have upon residents and their relatives. To explore the experiences of residents and their relatives of living restricted lives during the pandemic. This qualitative study was conducted as part of a 12-month, mixed-methods, phased design. From six purposively sampled care homes in England, 17 purposively sampled residents (all older adults) and 17 purposively sampled relatives participated in an individual, on-line interview, where they discussed their experiences of the restrictive measures implemented within their care home. Interviews were audio- and video-recorded with participants' permission and analysed using an inductive orientation to thematic analysis, with coding and theme development driven by the data content. Participants' experiences of care home restrictions varied; their impact was influenced by the existing pattern of relationships that residents and their relatives maintained within and beyond the care home. It was further influenced by the fact that many residents and relatives were still learning how to manage their relationships in the new context of living in a care home. Social distancing measures made care homes feel less homely and denied residents, staff and relatives physical touch and other forms of non-verbal communication. Many residents expressed a broad sense of gratitude that was associated with safety and well-being beyond the pandemic. As older adults, they put the pandemic, and its associated restrictions, within the larger context of their lives. Learning from the COVID-19 pandemic is paramount for governments, societies, policy makers, care home providers, care homes and their staff, residents and their families and friends, and researchers. Our study makes an important contribution as one of the first to study the impact of implementing isolation, social distancing and other restrictive measures for care home residents and their relatives in England.

Reading for Wellbeing (RfW) is a pilot initiative, aimed at improving mental health and well-being through supporting access and increasing opportunities to read for pleasure. RfW was implemented across six North-East local authorities in England and employed Community Reading Workers to support access to books and reading for targeted populations. The current study used realist methodology to understand context, potential mechanisms of action, acceptability and reported outcomes. Data generation and analysis were conducted iteratively, using focus groups, interviews and observations.The analysis of the collated data highlighted that a positive attitude towards reading and a desire for social connections were significant motivators for engagement with RfW. This paper postulates eight programme theories relating to that context, which describe key mechanisms within RfW linked to engagement with reading, well-being, connections and practice. The paper concludes that previous notions of positivity associated with reading for pleasure enable participants to experience RfW as a positive social encounter. This positive social encounter enhances participants’ multiple resistance resources such as increased sense of self-efficacy and connectedness that could impact on their sense of well-being.

Having faster plasma thawing devices could be beneficial for transfusion services, as it may improve the rapid availability of thawed plasma for bleeding patients, and it might remove the need to have extended pre-thawed plasma: thus, reducing unnecessary plasma wastage. The aims of this study were to assess (a) the thawing times and (b) in vitro haemostatic quality of thawed plasma using Barkey Plasmatherm V (PTV) at 37 and 45°C versus Barkey Plasmatherm Classic (PTC) at 37 and 45°C, Sarstedt Sahara-III Maxitherm (SS-III) at 37°C and Helmer Scientific Thermogenesis Thermoline (TT) at 37°C. Haemostatic quality was assessed using LG-Octaplas at three different time points: baseline (5 min), 24 and 120 h after thawing. The thawing time (SD) of 2 and 4 units was significantly different between different thawers. PTV at 45°C was the fastest method for both 2 and 4 units (7.06 min [0.68], 9.6 min [0.87], respectively). SS-III at 37°C being the slowest method (24.69 min [2.09] and 27.18 min [4.4], respectively) (p = < 0.05). Baseline measurements for all assays showed no significant difference in the prothrombin time, fibrinogen, FII, FV, protein C activity or free protein S antigen between all methods tested. However, at baseline PTV (both 37°C and 45°C) had significantly higher levels of FVII, FVIII and FXI and shortened activated partial thromboplastin time. PTV was the quickest method at thawing plasma at both 37 and at 45°C. The haemostatic quality of plasma thawed at 45 versus 37°C was not impaired. Thawing frozen plasma at 45°C should be considered.

Transformational leadership is a leadership style that is often compared to and contrasted with transactional leadership. Where the latter tends to be more task-orientated and has a part to play in specific managerial contexts, transformational leadership focuses on the power of relationships to inspire others to achieve a shared vision, with longer lasting effects. The benefits of transformational leadership place it as one of the most applied leadership styles in health care, with positive impacts seen on the workforce, organisational productivity, and patient outcomes. Developing transformational leaders across all levels of an organisation is strongly recommended, due to the benefits highlighted in the literature. Any organisation wishing to grow its transformational leaders must first identify intrinsic and extrinsic factors within the organisation and its culture that could act as obstacles. Authors are in agreement that the skills, knowledge and behaviours of a transformational leader can be learnt, therefore investment in such development programmes is important. This article explores the importance of transformational leadership and how staff can develop the competencies required to grow as a transformational leader in health and social care.