Identifying key health system components associated with improved outcomes to inform the re-configuration of services for adults with rare autoimmune rheumatic diseases: a mixed-methods study.

Background: Adults with rare autoimmune rheumatic diseases face unique challenges and struggles to navigate health-care systems designed to manage common conditions. Evidence to inform an optimal service framework for their care is scarce. Using systemic vasculitis as an exemplar, we aimed to identify and explain the key service components underpinning effective care for rare diseases.

Evaluation of a clinical leadership initiative.

Aim: To evaluate a clinical leadership initiative in mental health and care of older people settings.

Method: Clinical leaders (n=15), clinical nurse managers (n=6), and mentors (n=4) involved in the initiative received three questionnaires assessing perceived change, occupational stress and burnout. A nurse, a support worker and a doctor or therapist with whom the clinical leaders worked, each received the perceived change questionnaire (n=45).