This is a repository copy of Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH) : a stepped-wedge cluster-randomised trial. The Lancet. ISSN 0140-6736 https://doi.org/10.1016/S0140-6736(18)32521-2 eprints@whiterose.ac.uk https://eprints.whiterose.ac.uk/
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Implications of all the available evidenceDespite the success of some smaller projects, there was no survival benefit from a national quality improvement programme to implement a care pathway for patients undergoing emergency abdominal surgery. To succeed, large national quality improvement programmes need to allow for differences between hospitals and ensure teams have both the time and resources needed to improve patient care.
The findings highlight the importance of optimism in relationship to psychological distress in parents of children with cancer. Interventions targeting parents' optimism are recommended as a potential source of coping with adversity within this population.
Recent developments in UK health policy seek to place the service user at the centre of service delivery, although user involvement is a complex and challenging process. This paper explores the contribution of interprofessional (IP) education to user involvement, focusing on education and training within a UK cancer network. The impact of participation in educational projects on users is explored and the benefits and limitations of IP education are discussed. Triangulation of data from several sources suggests that the contribution of IP education to user involvement is contingent on professional constructions, which include ethical positions that are related closely to issues of power and control. In particular, professional protectionism may represent an ongoing difficulty in user involvement research and development. The research suggests that without dedicated support and training, some professionals are unlikely to engage willingly with involving users in service development.
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