Papers by Patrick A Crookes
Background: This paper describes the development and implementation of an intervention to facilit... more Background: This paper describes the development and implementation of an intervention to facilitate teamwork between general practice and outside allied and community health services and providers. Methods: A review of organizational theory and a qualitative study of 9 practices was used to design an intervention which was applied in four Divisions of General Practice and 26 urban practices. Clinical record review and qualitative interviews with participants were used to determine the key lessons from its implementation. Results: Facilitating teamwork across organizational boundaries was very challenging. The quality of the relationship between professionals was of key importance. This was enabled by joint education and direct communication between providers. Practice nurses were key links between general practices and allied and community health services. Conclusions: Current arrangements for Team Care planning provide increased opportunities for access to allied health. However the current paper based system is insufficient to build relationships or effectively share roles as part of a patient care team. Facilitation is feasible but constrained by barriers to communication and trust.
Bookmarks Related papers MentionsView impact
Aims To validate the Patients Assessment of Chronic Illness Care (PACIC) among patients with chro... more Aims To validate the Patients Assessment of Chronic Illness Care (PACIC) among patients with chronic disease in the Australian context and to examine the relationship between patient-assessed quality of care and patient and practice characteristics. Methods Cross-sectional analysis of baseline data in two independent health service intervention studies that involved patients with type 2 diabetes, ischaemic heart disease and/or hypertension in general practice. The first study involved 2552 patients from 60 urban and rural general practices. The second involved 989 patients from 26 practices in Sydney. Patients were mailed a questionnaire, which included the PACIC and Short Form Health Survey. Factor analysis was performed and the factor scores and total PACIC were analysed using multi-level regression models against practice and patient characteristics. Results Factor analysis revealed a two-factor solution with similar loading of PACIC items in both studies: one for shared decision making and self-management and the other for planned care. Practice characteristics were not related to PACIC scores. Scores were related to patient characteristics – education, retirement, type and number and duration of conditions. Conclusions The two-factor structure of the PACIC found in these Australian studies is different from the five-factor structure found in the US and the European studies. This may be related to differences in the way patients interact with the health system especially the use of Team Care plans. The association of total scores with patient characteristics was consistent with those found in other studies including a lack of association with gender, age and ethnicity. These findings should be taken into consideration when comparing patient-assessed quality of care between countries using this tool.
Bookmarks Related papers MentionsView impact
Design and setting: Data were collected as part of a cluster randomised controlled trial conducte... more Design and setting: Data were collected as part of a cluster randomised controlled trial conducted in 60 general practices in New South Wales, the Australian Capital Territory and Victoria between July 2006 and June 2008. Multilevel logistic regression analysis evaluated factors associated with the frequency of TCAs recorded in the 12 months after baseline, and multilevel multivariable analysis examined the association between TCAs and patient-assessed quality of chronic illness care, adjusted for patient and practice characteristics.
Main outcome measures: Frequency of TCAs; Patient Assessment of Chronic Illness Care (PACIC) scores.
Results: Of 1752 patients with clinical audit data available at 12-month follow-up, 398 (22.7%) had a TCA put in place since baseline. Women, patients with two or more chronic conditions, and patients from metropolitan areas had an increased probability of having a TCA. There was an association between TCAs and practices with solo general practitioners and those with greater levels of teamwork involving non-GP staff for the control group but not the intervention group. Patients who had a TCA self-assessed their quality of care (measured by PACIC scores) to be higher than those who did not.
Conclusions: Findings were consistent with the purpose of TCAs to provide multidisciplinary care for patients with longer-term complex conditions. Significant barriers to TCA use remain, especially in rural areas and for men, and these may be more challenging to overcome in larger practices.
Bookmarks Related papers MentionsView impact
PURPOSE: To describes the perceptions of the ward atmosphere of psychiatric hospitals from the pe... more PURPOSE: To describes the perceptions of the ward atmosphere of psychiatric hospitals from the perspective of the relatives of people who were inpatients in those hospitals. DESIGN AND METHODS: A nonexperimental descriptive survey was used. Data were collected using the Arabic version of Moos Ward Atmosphere Scale Ideal and Real forms. FINDINGS: Data indicate that even though relatives of Jordanian mental health patients were generally positive about the ward atmosphere, they would like to see changes. PRACTICE IMPLICATIONS: By describing their current and ideal treatment environments , participants have provided information that can guide interventions to change the ward atmosphere and thus help foster better patient treatment outcomes.
Bookmarks Related papers MentionsView impact
Background: A competitive Carrick Institute Competitive Grant (CG7-523) was obtained to explore w... more Background: A competitive Carrick Institute Competitive Grant (CG7-523) was obtained to explore what skills were taught and what assessment of practice approaches were used in nursing programmes in Australia. The intention was twofold; firstly to identify what skills were being taught which would contribute to the development of an assessment of practice toolkit for eligibility to practice programmes in Australia. This paper specifically reports on the skills taught in nursing programmes in Australia. Methods: A qualitative research methodology was used through a documentary analysis of university curriculum documents. This was undertaken independently by two researchers; the data was then reviewed by an expert group. The skills taught were explored, listed and categorised using a conceptual framework, then refined and reported. Results: Over 1300 skills were initially identified within nursing programmes across Australia; these were 'clustered' using a framework into 30 skills areas. These included psychomotor skills to skills areas that relate to human factors such as communication, team work, leadership and supervision. Conclusions: A wide range of skills were referred to in university nursing programme curriculae in Australia. There were some significant variations; some universities taught their student nurses how to manage a client/patient requiring external invasive ventilator support. There were however a number of similar skills areas identified; such as acute care assessment skills (monitoring vital signs) and mental health assessment skills. The range of skills taught within nursing curriculum is challenging as there is only limited time to expose students to those skills and afford the student the opportunity to practice those skills in order to achieve competence prior to registration.
Bookmarks Related papers MentionsView impact
Background: In recent years there has been a growth in leadership development frameworks in healt... more Background: In recent years there has been a growth in leadership development frameworks in health for the existing workforce. There has also been a related abundance of leadership programmes developed specifically for qualified nurses. There is a groundswell of opinion that clinical leadership preparation needs to extend to preparatory programmes leading to registration as a nurse. To this end a doctoral research study has been completed that focused specifically on the identification and verification of the antecedents of clinical leadership (leadership and management) so they can shape the curriculum content and the best way to deliver the curriculum content as a curriculum thread. Objectives: To conceptualise how the curriculum content, identified and verified empirically, can be structured within a curriculum thread and to contribute to the discussion on effective pedagogical approaches and educational strategies for learning and teaching of clinical leadership. Design: A multi-method design was utilised in the research in Australia. Drawing on core principles in critical social theory, an integral curriculum thread is proposed for pre-registration nursing programmes that identifies the antecedents of clinical leadership; the core concepts, together with the continuum of enlightenment, empowerment, and emancipation. Conclusions: The curriculum content, the effective pedagogical approaches and the educational strategies are supported theoretically and we believe this offers a design template for action and a way of thinking about this important aspect of preparatory nursing education. Moreover, we hope to have created a process contributing to a heighten sense of awareness in the nursing student (and other key stakeholders) of the what, how and when of clinical leadership for a novice registered nurse. The next stage is to further test through research the proposed integral curriculum thread.
Bookmarks Related papers MentionsView impact
Background: There appears to be a sense of disappointment with the product of contemporary nursin... more Background: There appears to be a sense of disappointment with the product of contemporary nursing programs in Australia in that new graduate RNs are often referred to as not possessing appropriate skills by clinical colleagues. This work identifies the skills that the profession believes that newly graduating RN's should possess at the point of registration.
Bookmarks Related papers MentionsView impact
Please cite this article in press as: Brown, R. A., & Crookes, P.A. How do expert clinicians asse... more Please cite this article in press as: Brown, R. A., & Crookes, P.A. How do expert clinicians assess student nurses competency during workplace experience? A modified nominal group approach to devising a guidance package. Collegian (2016), Summary This paper presents data regarding how experienced clinicians and academics said they assess the competency of nursing students progressing through eligibility to practice programmes in Australian universities. The development of competence during nursing education programmes is an essential part of university based nursing eligibility to practice courses and so facilitating consistent, reliable and valid assessment of the demonstration of those competencies is critical. A consensus methodology incorporating a modified nominal group technique was used to explore how clinicians assessed nursing students whilst on workplace experience. These assessment strategies were then analysed to develop guidance notes for assessors. Consensus was reached regarding strategies for assessing the competence of nursing students as they progress through their programme of study based on the views of experienced clinicians and academics. This work culminated in the production of guidance notes to assist assessors to feel confident that the student they were assessing was competent. The identification of strategies and activities, including the 'work of the nurse' could be observed within specific practice activities. (R.A. Brown), [email protected] (P.A. Crookes). 1 Tel.: +61 2 4221 3174.
Bookmarks Related papers MentionsView impact
Providing institutionally recognized evidence of community engaged scholarship has long been prob... more Providing institutionally recognized evidence of community engaged scholarship has long been problematic for engaged scholars when applying for recognition through promotion or probation pathways. To combat this, the University of Wollongong [in New South Wales, Australia] developed an online tool for use by engaged scholars to track and measure their engagement activities in a consistent and institutionally recognized form. This article outlines the process that was undertaken to develop the online system for measuring and tracking engagement (the MaTE tool). It outlines the initial recognition of the key issues arising from a comprehensive review of the literature; the drafting process undertaken to develop a prototype for the tool; and the interview stage and subsequent re-drafting process and finalization of the tool. The article concludes with a consideration of future directions for the tool and its further implementation at the university.
Bookmarks Related papers MentionsView impact
With an academic workforce undergoing transformation, it is vital that universities rethink how t... more With an academic workforce undergoing transformation, it is vital that universities rethink how they define and value scholarship through their processes for academic promotion. A key part of this rethink is to review and refine existing documentation about promotion to reflect changing conceptions of scholarly work, in a way that enables scholars from non-traditional academic pathways to be valued equally through the promotion process with their more traditional counterparts. This process of reviewing scholarship was the aim of a promotions review project which began at the University of Wollongong in 2011 and concluded with the production of an Academic Performance Framework (APF). This framework outlines a new way of articulating performance expectations in order to recognise scholarship more broadly, as well as to emphasise more clearly the imperative for academics to be able to articulate evidence of the impact of their work.
Bookmarks Related papers MentionsView impact
This ‘catalogue’ sets out possible measures and sources of evidence that are aimed at the individ... more This ‘catalogue’ sets out possible measures and sources of evidence that are aimed at the individual staff member. The ‘catalogue’ draws from an extensive review of the literature and consultation with academic staff to articulate measures of impact and esteem across a range of scholarly areas, and provide examples of supporting evidence, which can then act as guidelines for the writing of individual impact statements. It provides definitions of key terms, tables of activities and links to tools for calculating various forms of scholarly impact.
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Australian journal of primary health, 2013
There is evidence for a team-based approach in the management of chronic disease in primary healt... more There is evidence for a team-based approach in the management of chronic disease in primary health care. However, the standard of care is variable, probably reflecting the limited organisational capacity of health services to provide the necessary structured and organised care for this group of patients. This study aimed to evaluate the impact of a structured intervention involving non-GP staff in GP practices on the quality of care for patients with diabetes or cardiovascular disease. A cluster randomised trial was undertaken across 60 GP practices. The intervention was implemented in 30 practices with staff and patients interviewed at baseline and at 12-15 months follow up. The change in team roles was evaluated using a questionnaire completed by practice staff. The quality of care was evaluated using the Patient Assessment of Chronic Illness Care questionnaire. We found that although the team roles of staff improved in the intervention practices and there were significant differe...
Bookmarks Related papers MentionsView impact
Nurse education today, 1997
Bookmarks Related papers MentionsView impact
Health Policy, 2011
Chronic diseases require a multidisciplinary approach to provide optimal patient care in general ... more Chronic diseases require a multidisciplinary approach to provide optimal patient care in general practice. In Australian general practice, this usually involves referral to an allied health provider outside the practice. This study explored the patient and practice factors associated with referral of patients with diabetes, ischaemic heart disease (IHD) or hypertension to external allied health providers (AHPs). A multilevel analysis of data collected as part of a quasi-experimental study was conducted in 26 practices in Sydney. The frequency of patient-reported referral to AHPs 6-months post-intervention was measured against patient and practice characteristics assessed by patients and practice staff questionnaires. Seven per cent of the total variance in the referrals was due to differences between practices and 93% attributed to differences between patients. Previous referral, age over 45 years, multiple conditions, longer illness duration, poor mental and physical health were associated with the likelihood of referral to AHPs but not socio-economic status, patient self-assessment of care and the intervention. Those attending practices with over three GPs were more likely to be referred. Referral to multidisciplinary care for patients with long term conditions was appropriately linked to the complexity, duration and impact of these conditions. The lack of association between the intervention and the frequency of referral suggests that factors other than knowledge and communication such as the accessibility of the allied health services may have been more important in determining referral.
Bookmarks Related papers MentionsView impact
Collegian, 2012
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Bookmarks Related papers MentionsView impact
Uploads
Papers by Patrick A Crookes
Main outcome measures: Frequency of TCAs; Patient Assessment of Chronic Illness Care (PACIC) scores.
Results: Of 1752 patients with clinical audit data available at 12-month follow-up, 398 (22.7%) had a TCA put in place since baseline. Women, patients with two or more chronic conditions, and patients from metropolitan areas had an increased probability of having a TCA. There was an association between TCAs and practices with solo general practitioners and those with greater levels of teamwork involving non-GP staff for the control group but not the intervention group. Patients who had a TCA self-assessed their quality of care (measured by PACIC scores) to be higher than those who did not.
Conclusions: Findings were consistent with the purpose of TCAs to provide multidisciplinary care for patients with longer-term complex conditions. Significant barriers to TCA use remain, especially in rural areas and for men, and these may be more challenging to overcome in larger practices.
Main outcome measures: Frequency of TCAs; Patient Assessment of Chronic Illness Care (PACIC) scores.
Results: Of 1752 patients with clinical audit data available at 12-month follow-up, 398 (22.7%) had a TCA put in place since baseline. Women, patients with two or more chronic conditions, and patients from metropolitan areas had an increased probability of having a TCA. There was an association between TCAs and practices with solo general practitioners and those with greater levels of teamwork involving non-GP staff for the control group but not the intervention group. Patients who had a TCA self-assessed their quality of care (measured by PACIC scores) to be higher than those who did not.
Conclusions: Findings were consistent with the purpose of TCAs to provide multidisciplinary care for patients with longer-term complex conditions. Significant barriers to TCA use remain, especially in rural areas and for men, and these may be more challenging to overcome in larger practices.
The intent of the presentation was to demonstrate SOTL leadership as well as talking about it...
The pilot TPP was influenced heavily by the UK’s Higher Education Academy’s (HEA) Thematic Change Programmes and benefited hugely from the support of HEA staff, in particular, the second author. The pilot TPP was supported by the first author’s secondment to the Commonwealth Government’s Office for Learning and Teaching (OLT) in Australia. A condition of the secondment was that the pilot TPP must focus on ‘enhancing the reward and recognition of good teaching in Australian Higher Education (HE)’. A recently signed MoU (2014) between the OLT and the HEA was a major facilitator of the project.
The paper explains the intention(s) of what was to become the TPP and how it was conceptualised and run in conjunction with the HEA in both Australia and the UK. Thirteen (13) Australian Universities/HE institutions took part in the pilot, whilst 9 UK universities took part in the UK version of the programme (The HEA’s Thematic Change Programme Promotion, Process and Policy) in 2014. Having briefly detailed the content and process of the pilot TPP, the paper then presents details of feedback received via web-based surveys and formal interviews with TPP participants (ethics approval having been granted by the University of Tasmania) and closes with some evidence-based conclusions as to what seemed to have worked in the pilot TPP and why. Some recommendations will then be made as to what people in other Higher Education sectors might learn from the pilot TPP.
We believe this paper will be of interest and utility to a wide range of people; from individual academics, through to academic developers and educational leaders and policy-makers. It is particularly pertinent to the overarching conference theme of Leading Learning and the Scholarship of Change and to this theme in particular, because it will explore how institutional initiatives related to enhancing reward and recognition for teaching were successfully implemented and embedded in a number of HE institutions. It will also demonstrate that in some cases, such initiatives have been influenced and /or facilitated by high quality SoTL work. It will be seen that this project speaks to ways in which SOTL processes and outputs have been influential in changing practice at the institutional and sector levels, internationally.