Abstract: Purpose: Initial briefs (programs) were examined in order to obtain an overview of current practice in documenting the briefing process for new health care buildings in Sweden.
Methodology: An audit instrument was developed and used to examine briefs for the content and quality of information and to determine whether and to what extent the information was comprehensive and patient oriented.
Findings: The results indicate that few strategic briefs make use of evidence to support their statements. Moreover, few briefs had an explicitly patient-focused goal for the project or measurable outcomes.
Implication for practice: This new audit approach can be applied in various organisations and over time to improve the briefing process and create clearer goals and guidelines.
Originality/value: The present study contributes with an audit of written briefs. The question of whether the use of briefing and a systematic brief make a significant contribution to the high quality of design solutions remains unanswered, as is also the case of whether the brief, in general, reflects the briefing process. Despite the recent focus on improving the quality of the briefing process, there is a lack of knowledge concerning the documentation resulting from the briefing process. Studies are needed that employ different approaches in order to accept or reject the assumption that the briefs are an accurate reflection of the briefing process.
Abstract: This article presents a conceptual model of the care planning process developed to identify the hypothetical links between structural, process and outcome factors important to the quality of the process. Based on existing literature, it was hypothesized that a thorough assessment of patients' health needs is an important prerequisite when making a rigorous diagnosis and preparing plans for various care interventions. Other important variables that are assumed to influence the quality of the process are the care culture and professional knowledge. The conceptual model was developed as a system dynamics causal loop diagram as a first essential step towards a computed model. System dynamics offers the potential to describe processes in a nonlinear, dynamic way and is suitable for exploring, comprehending, learning and communicating complex ideas about care processes.
Abstract: BACKGROUND: In order to facilitate the collaborative design, system dynamics (SD) with a group modelling approach was used in the early stages of planning a new stroke unit. During six workshops a SD model was created in a multiprofessional group. AIM: To explore to which extent and how the use of system dynamics contributed to the collaborative design process. METHOD: A case study was conducted using several data sources. RESULTS: SD supported a collaborative design, by facilitating an explicit description of stroke care process, a dialogue and a joint understanding. The construction of the model obliged the group to conceptualise the stroke care and experimentation with the model gave the opportunity to reflect on care. CONCLUSION: SD facilitated the collaborative design process and should be integrated in the early stages of the design process as a quality improvement tool.
Abstract: This study describes the development of a system dynamics model in a design process devoted to planning a new stroke unit. The model was created with a group modeling approach in which several professionals were involved. The advantage of using system dynamics is the simplicity and the ability to reveal the underlying structure of complex problem. Moreover, the method is transparent, showing the model boundaries and explicitly defined the variables and the relationships between them.
Abstract: Earlier studies have shown that patients are dissatisfied with the information they receive from doctors and nurses. The purpose of this study was to analyze satisfaction with information and quality of life in patients with cancer undergoing chemotherapy, considering the patient's information preference. Data were collected during interviews with 30 consecutive patients undergoing chemotherapy for cancer. The subject of the interviews was the satisfaction of patients with the information they received, and additional measures used were the Miller Behavioral Styles Scale and EORTC-QLQ-30. The results showed that 21 of 30 patients were satisfied with the information they received from health care. Married patients or cohabitants were satisfied more often than single patients. No significant differences in quality of life could be found between satisfied and dissatisfied patients. Regarding information preferences, the dissatisfied patients reported more information-avoiding behavior than those who were satisfied. The results must be interpreted cautiously because of the study's limitations, but one clinical implication can be stated: There is value in being aware of patients' information-seeking/avoiding behavior before starting to inform them.
Abstract: The aim of the present study was to monitor the health-related quality of life (HRQOL) of patients with head and neck cancer or haematological malignancies during a period from before to after medical treatment, and to investigate the relationships between patient experiences of oral symptoms and HRQOL. The sample consisted of 41 consecutive patients. At the start, during and end of radiotherapy or the second/third cycle of chemotherapy, patients rated their experiences of oral symptoms on a 100-mm visual analogue scale and completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30 and the EORTC QLQ H&N35 (head and neck patients). At the end of treatment, an interview was done regarding the perceived influence of oral status on HRQOL. Among patients receiving radiotherapy, HRQOL tended to decrease over time, and oral symptoms increased. Patients who reported that their oral symptoms had influenced their everyday life (56%) reported more severe oral symptoms and lower HRQOL scores at the end of treatment when the oral symptoms were most intense. The findings from correlational analyses support the patients' reports from the interviews. For patients receiving chemotherapy for haematological malignancies, the quality of life did not change during the chemotherapy cycle. They reported very few oral symptoms, and very few reported that oral symptoms had any influence on their HRQOL. However, the correlational data indicate a relation between oral symptoms and HRQOL. Patients who reported more severe oral symptoms also reported lower HRQOL scores. The results demonstrate that oral status is related to HRQOL in these patient groups.
