The Role of Patient-Reported Experience and Outcome Measures in Kidney Health Equity-Oriented Quality Improvement.

Risk, prevalence, management, and outcomes in chronic kidney disease (CKD) are influenced by social and broader determinants of health. Consequently, there are wide-ranging kidney health inequities. As patients are key stakeholders, their perspectives on the care they receive and on health status are central in guiding health system improvement, particularly to reduce the impact of disadvantage.

Becoming frail: A more than human exploration.

'Frailty' is increasingly used as a clinical term to refer and respond to a particular bodily presentation, with numerous scores and measures to support its clinical determination. While these tools are typically quantitative in nature and based primarily on physical capacity, qualitative research has revealed that frailty is also associated with a range of social, economic and environmental factors. Here, we progress the understanding of frailty in older people via a new materialist synthesis of recent qualitative studies of frailty and ageing.

Transferring, translating and transforming knowledge: the role of brokering in healthcare networks.

Purpose: This research examines how knowledge and information are managed within two care networks. We develop a conceptual framework drawing on the notion of brokering and the 3T framework, which is used to describe the relative complexity of boundaries (referred to in the framework as syntactic, semantic and pragmatic) as well as capabilities and processes required to exchange information within the network. Previous research on brokering has focused on healthcare managers and professionals, but this research extends to patients and caregivers.

Talking about frailty: The role of stigma and precarity in older peoples' constructions of frailty.

The clinical identification of frailty is increasingly thought to be important in countries with ageing populations. Understanding how older people labelled as frail make sense of this categorisation is therefore important. A number of recent studies have reported negative perceptions of the term among older people themselves.

Frailty as biographical disruption.

Biographical disruption positions the onset of chronic illness as a major life disruption in which changes to body, self and resources occur (Sociology of Health & Illness, 4, 1982, 167-182). The concept has been used widely in medical sociology. It has also been subject to critique and development by numerous scholars.

An integrative approach to improving patient care pathways.

Purpose: Globally, healthcare managers continue to struggle with increasing demands for their services being delivered with limited or shrinking resources. It is, therefore, clear that systems, processes and practices need to change to meet these challenges. The purpose of this paper is to assess how integrating two improvement technologies, Lean and integrated care pathways (ICP) might help.

Evaluating Lean in healthcare.

Purpose: The purpose of this paper is to present findings relating to how Lean is implemented in English hospitals.

Design/methodology/approach: Lean implementation snapshots in English hospitals were conducted by content analysing all annual reports and web sites over two time periods, giving a thorough analysis of Lean's status in English healthcare.

Findings: The article identifies divergent approaches to Lean implementation in English hospitals.

Lean in healthcare: the unfilled promise?

In an effort to improve operational efficiency, healthcare services around the world have adopted process improvement methodologies from the manufacturing sector, such as Lean Production. In this paper we report on four multi-level case studies of the implementation of Lean in the English NHS. Our results show that this generally involves the application of specific Lean 'tools', such as 'kaizen blitz' and 'rapid improvement events', which tend to produce small-scale and localised productivity gains.

How healthy is the annual health check?

Purpose: This paper aims to provide an assessment of organisational implementation of the healthcare standards focusing on the annual health check (AHC) in the UK NHS.

Design/methodology/approach: Using a postal questionnaire a national survey of all acute and specialist NHS Trusts in England was undertaken. The survey yielded a total of 102 responses, which equates to a 59 per cent response rate.

Success factors for implementation of the balanced scorecard in a NHS multi-agency setting.

Even though the balanced scorecard (BSC) has become a highly popular performance management tool, usage in local public sector National Health Service (NHS) organisations is still rare. This paper conditionally outlines some grounds in supporting such usage. In particular underlying conceptual concerns with the BSC system and its implementation pitfalls require full consideration.