Trust‐Level Risk Evaluation and Risk Control Guidance in the NHS East of England

In recent years, the healthcare sector has adopted the use of operational risk assessment tools to help understand the systems issues that lead to patient safety incidents. But although these problem‐focused tools have improved the ability of healthcare organizations to identify hazards, they have not translated into measurable improvements in patient safety. One possible reason for this is a lack of support for the solution‐focused process of risk control. This article describes a content analysis of the risk management strategies, policies, and procedures at all acute (i.e., hospital), mental health, and ambulance trusts (health service organizations) in the East of England area of the British National Health Service. The primary goal was to determine what organizational‐level guidance exists to support risk control practice. A secondary goal was to examine the risk evaluation guidance provided by these trusts. With regard to risk control, we found an almost complete lack of useful guidance to promote good practice. With regard to risk evaluation, the trusts relied exclusively on risk matrices. A number of weaknesses were found in the use of this tool, especially related to the guidance for scoring an event's likelihood. We make a number of recommendations to address these concerns. The guidance assessed provides insufficient support for risk control and risk evaluation. This may present a significant barrier to the success of risk management approaches in improving patient safety.     

Staffing Call Centers with Uncertain Arrival Rates and Co‐sourcing

In a call center, staffing decisions must be made before the call arrival rate is known with certainty. Once the arrival rate becomes known, the call center may be over‐staffed, in which case staff are being paid to be idle, or under‐staffed, in which case many callers hang‐up in the face of long wait times. Firms that have chosen to keep their call center operations in‐house can mitigate this problem by co‐sourcing; that is, by sometimes outsourcing calls. Then, the required staffing N depends on how the firm chooses which calls to outsource in real time, after the arrival rate realizes and the call center operates as a M/M/N + M queue with an outsourcing option. Our objective is to find a joint policy for staffing and call outsourcing that minimizes the long‐run average cost of this two‐stage stochastic program when there is a linear staffing cost per unit time and linear costs associated with abandonments and outsourcing. We propose a policy that uses a square‐root safety staffing rule, and outsources calls in accordance with a threshold rule that characterizes when the system is “too crowded.” Analytically, we establish that our proposed policy is asymptotically optimal, as the mean arrival rate becomes large, when the level of uncertainty in the arrival rate is of the same order as the inherent system fluctuations in the number of waiting customers for a known arrival rate. Through an extensive numerical study, we establish that our policy is extremely robust. In particular, our policy performs remarkably well over a wide range of parameters, and far beyond where it is proved to be asymptotically optimal.     

Context matters: real-world and utilization-focused evaluation strategies to support change and improvement in child welfare

This article examines the importance of context in evaluative inquiry. Following guidelines from real-world and utilization-focused evaluation frameworks, four projects are described to illustrate one foundation's pragmatic approach to evaluation that values collaboration, methodological appropriateness, and utilization. The authors contend that such an approach helps to ensure meaningful and actionable results in child welfare because it is responsive to local agency information and capacity needs while simultaneously contributing to the knowledge base of the field.     

Number of sexual partners and sexual assertiveness predict sexual victimization: do more partners equal more risk?

In previous studies, number of sexual partners and sexual assertiveness were examined as independent risk factors for sexual victimization among college women. Using a sample of 335 college women, this study examined the interaction of number of sexual partners and sexual assertiveness on verbal sexual coercion and rape. Approximately 32% of the sample reported unwanted sexual intercourse, 6.9% (n = 23) experienced verbal sexual coercion, 17.9% (n = 60) experienced rape, and 7.2% (n = 24) experienced both. As number of sexual partners increased, instances of verbal sexual coercion increased for women low in relational sexual assertiveness but not for women high in relational sexual assertiveness. A similar relationship was not found for rape. Among women who experienced both verbal sexual coercion and rape, increases in number of partners in the context of low refusal and relational assertiveness were associated with increases in verbal sexual coercion and rape. Findings suggest sexual assertiveness is related to fewer experiences of sexual coercion.     

Translating messages from research on child development into social work training and practice

Social work training should equip students with both the knowledge and the skills required for good practice. Although research messages are available through books and papers, they may more easily be conveyed through the repeated use of practice tools which have been developed from research findings. The Looking After Children Assessment and Action Records have been used in formal social work training to help students develop competencies, but their value as a means of conveying a knowledge basis of key issues in child development has yet to be exploited. The Children and Families Assessment Programme has a similar potential, to help practitioners set child protection issues within a developmental framework and further their understanding of those factors that impede children's satisfactory progress. New requirements to provide routine data on children's progress for aggregation and analysis can both improve practitioners' skills and understanding of the purpose of management information, as well as providing evidence of the effectiveness of services.     

‘Opportunity led work’: 2. The framework

This paper presents a framework for the analysis of opportunity led work, which is intended to enable students and practitioners to think their way through situations and opportunities which arise in daily practice, especially in the group care setting, and to help them to review and learn from their handling of such situations. The framework is based upon a process model, focusing in turn on the stages of Observation and Assessment, Decision-Making, Action — which sub-divides into short term/behavioural interventions and longer term/therapeutic interventions — and Closure. There is an emphasis in the illustrative material on the use of this concept in residential child care.     

Letter to the Editor

Competency-based assessment required by the Council on Social Work Education was an impetus for the development of a practice evaluation design for use by clinical practice students in their field practicum. The standards-based comparison design was developed by the author as an alternative to single-system design. Student exemplars illustrate the application of this model.     

Research Knowledge Assessment: A Study of MSW Students’ Acquisition and Retention of Research Knowledge

ABSTRACT

In response to the need for meaningful data about student learning in research courses, we developed and implemented the Research Knowledge Assessment instrument to measure MSW student acquisition, application, and retention of research knowledge over a 3-year period across the research curriculum. Initial findings indicated that students entered the foundation research methods course with little research knowledge, gained some knowledge during the course but not at an acceptable level, and lost 22% of the gain by the beginning of the concentration research course. The greatest knowledge acquisition was in sampling and the least in theory and question development. Knowledge acquisition was associated with not having a BSW and not having adjunct faculty as a research instructor.     

Using a model of group psychotherapy to support social research on sensitive topics

This article describes the exploratory use of professional therapeutic support by social researchers working on a sensitive topic. Talking to recently bereaved parents about the financial implications of their child’s death was expected to be demanding work, and the research design included access to an independent psychotherapeutic service. Using this kind of professional support is rare within the general social research community, and it is useful to reflect on the process. There are likely to be implications for collection and interpretation of data, research output and the role and experience of the therapist. Here, the primary focus is the potential impact on researcher well‐being.