This study examines practitioners' compliance and noncompliance with risk/needs assessment tools, using a national survey of frontline community corrections staff. Focusing on respondents required to complete tools and make decisions based on them, analysis showed that tools were mostly filled out when required, but decisions were not always based on the tool result. latent class analysis suggests about half of the tool-using subgroup were "substantive" compliers who completed tools carefully and honestly and tended to use them for decision making. The remaining tool users were "formal" in their compliance: filling out the tools, but often making decisions that did not correspond with tool results, and in some cases even manipulating the information included in them. Multivariate analysis suggests that practitioners' belief in risk/needs tools, agency monitoring and training, perceptions of agency procedural justice, and agencies' projected confidence in their local risk/need tool may help explain patterns of compliance and noncompliance.
A movement worldwide, and specifically new to our hospital, is the implementation of Patient- and Family-Centered Care. We were unsure, however, what the needs were of our patients' families. This triangulated study, on a 28-bed oncology unit, studied family members at the bedside. We asked family members what their needs were in a three-step process (open-ended interview, use of the Draw a Bridge art therapy technique, and the Family Inventory of Needs survey). Nineteen interviews revealed needs for physical comfort, emotional support, cultural sensitivity, recognition of help provided by family members and improved pain management. Art therapy revealed the stress of caregiving and helped to uncover unmet needs for interviewers to explore. The FIN identified that care at home after discharge was a major worry. Knowledge of family members' needs while a loved one is in the hospital allows for planning and provision of modalities to assist them in their caregiving.
We examined implementation outcomes several years after rollout of the Youth Level of Service/Case Management Inventory (YLS/CMI) risk/need assessment (RNA) tool in five diverse Pennsylvania county juvenile probation offices. Offices had policies to direct the use of the YLS/CMI, and officers tended to view the tool favorably, complete it, and apply it in their work. However, there were also variations in the extent of implementation. These seemed related to differences in office leadership and climate, implementation and quality assurance strategies, probation officers’ support for reforms, and the broader stakeholder environment. Results are largely consistent with implementation science principles.
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