Designing a recovery-orientated system of care: A community operational research perspective

Abstract

Theory suggests health focused Community Operational Research (COR) projects and their participants can benefit from balancing a "glass half empty" concern for deficits, problems and weaknesses with a "glass half full" concern for identifying health assets and bringing them into use. We present a COR systemic intervention in the care of persons with addiction and substance use/ misuse problems in Clydeplace, Scotland (anonymised). Our research reveals how the Whole Person Recovery System is situated within a wider General Community Recovery System that offers a variety of health assets that can be mobilised to create and increase recovery capital. The project involved 20 semi-structured interviews, two asset mapping workshops, a certificated "health issues" course completed by seven "champions", and action planning and implementation. In the interviews participants found gaps were more easily identified than assets. During the workshops participants identified 388 discrete assets and gaps, prioritised these using a simple voting system and developed a series of actions to mobilise health assets including bringing into use local facilities and amenities and involving a number of individuals and groups in local events and activities. Our study suggests that even in the impoverished system of Clydeplace, a "Community Catalyst" in the form of a Community Operational Researcher can act to stimulate the co-development of health assets, build relationships and enable the creation of social capital. It is not clear though when such systems become "self-catalysing." Keywords OR in health and social care, Community Operational Research, substance misuse, social capital, recovery capital, health assets, systems. 1. Community Operational Research and health and social care improvement Operational Research (OR) has a longstanding tradition of social responsibility (e.g., see Ackoff, 1974; Churchman, 1970; Ormerod & Ulrich, 2013; Rosenhead, 1986,) and has frequently challenged OR scholars to tackle societal issues. This mission has particularly been taken on board by scholars focussing on community-based OR interventions. While the term 'Community Operational Research' (COR) originates in the UK (Rosenhead, 1986) there is a long international history of often eminent contributions to community-based interventions of diverse theoretical and practical kinds from outwith and often prior to the OR movement, including Dewey's early 20th century experimentalist and progressive educational movement (Masters, 1995), Moreno's psychodrama with Viennese

Exploring essential components of addiction recovery: a qualitative study across assisted and unassisted recovery pathways

“…Professionals can gain understanding of these personal needs of the individual in recovery they work with by building close relationships (Miller & Moyers, 2015;Skipper & DuPont, 2010;Topor et al, 2018). Furthermore, building on their insight into what service users perceive as important and meaningful, professionals are able to identify possible sources of support in the social context and communities of those in recovery and support service users to build on these resources (Walsh et al, 2019).…”

Factors affecting collaboration between clinical and community service organizations

“…Extrapolating from our data, we propose a novel conceptual model that describes iterative cycles of bridging leadership, provisional teamwork, and learning processes in ongoing collaborative work (Figure 1). By specifically conceptualizing the collaborative interaction that develops between organizational entities over time, this model extends past conceptualizations of community ecosystems linking aspects of social care, such as the whole community recovery system model developed in the context of substance use (Walsh et al, 2019), as well as integrated care models that have articulated multiple components of organizational integration to include interpersonal relationships and shared functions (Singer et al, 2018).…”

Health Systems approach to the application of privacy protection for patients accessing health facilities in Ghana

“…There is need for community approach to health systems strengthening [14]. This is imperative because globally, healthcare is confronted with cost and quality challenges -making healthcare sustainability very problematic [14].…”

“…There is need for community approach to health systems strengthening [14]. This is imperative because globally, healthcare is confronted with cost and quality challenges -making healthcare sustainability very problematic [14]. As a result, many countries continue to plan within limited resources and planning in such environment require community led approach that will generate social capital and encourage mobilisation of health asset within local communities, all of which are essential for social capital recovery.…”